Orthopedic Occupational Injuries
The Sanders Clinic for Orthopaedic Surgery and Sports Medicine accepts patients who have been
involved in occupational accidents. At all times, the Sanders Clinic puts reason over technology in the treatment of occupational
injuries and diseases. A special technology or procedure is not readily employed simply because it exists. And continued work is
recommended for the majority of patients.
Our philosophy and approach to occupational injuries is no different than that applied to those incurred from sports or any other
activity. We strengthen the injury and surrounding area with the least invasive treatment plan, in order to get patients back to
their activities as fast as possible.
Active exercise and aerobic conditioning is one of the most successful methods used for rapid recovery. It is incorporated into
every patient plan at the Sanders Clinic and has proven to significantly reduce recovery time and eliminate the need for other
injury supports.
Patients suffering from work-related accidents and injuries are given the same reconditioning program
as athletes at the clinic, which consists of a self-supervised program emphasizing healthy food choices for weight management and a
cardiovascular exercise program for overall well-being and continued strengthening.
Other recommendations are made to transition the patient back into their work environment, such as advising a periodic rotation in
tasks as well as variation in physical positions and approach to activities within the workplace.
This program does more than reduce the span of time between injury and a patient's return to the workplace.
Dr. Sanders believes that treatment should be performed in the most inexpensive and least restrictive
environment possible. He is opposed to excessive and invasive diagnostic tests, such as Myleograms and Discograms, as they rarely
provide a diagnosis that leads to an efficacious treatment.
He does not regularly prescribe, advocate, or approve the use of expensive durable medical equipment such as custom made back or
knee braces, chiropractic, or rehabilitation. He further does not recognize the efficacy of work conditioning, work hardening, or
psychiatric based pain management programs. Nor does he regularly recommend invasive pain management, especially spinal cord
stimulators, or open surgery for occupational injuries of the spine in the absence of clear cut objective evidence of Neurologic
deficit or objective documentation of instability on lateral X-rays.
Dr. Sanders is in complete agreement with the February, 2004, New England Journal of Medicine opinion that spinal fusion to treat
herniated discs and spinal stenosis is appropriate only in rare cases.
He further believes that Reflex Sympathetic Dystrophy, Complex Regional Pain Syndrome, and Post Traumatic Stress Disorder are over
diagnosed and is far more often factitious than it is legitimate. These faulty diagnoses leading to unnecessary treatments drive up
the already astronomical cost of treating injured employees in Texas and are a complete waste of valuable resources.
Dr. Sanders believes that Functional Capacity Examinations (FCE) are subjective tests and subject to examinee bias. For that reason
he believes that the FCE is irrelevant and neither orders nor relies on them.
He believes that injured employees, who continue to complain of pain after completion of an ordinary course of treatment, require
rare medical follow-up visits for purposes of prescribing a non-narcotic analgesic or an anti-inflammatory. Ibuprofen, or Advil,
obtained over the counter would be a satisfactory alternative. These injured employees do not require Class 2 or Class 3 narcotic
analgesics or skeletal muscle relaxers.
Dr. Sanders further believes that tobacco use should be discontinued. And he emphasizes that healthy choices at the dinner table for
weight reduction - including a program of aerobic fitness such as brisk walking, bicycling, Stairmaster, or jogging for 45 minutes
per day, five days per week - is of far greater value than any other intervention. An injured employee who maintains that he is in
too much discomfort to exercise, indicates a lack of desire to recover and confirms malingering for continued financial gain. Under
such circumstances, all treatments should be discontinued.
The "Home Page" of the Texas Workman's Compensation Website clearly states, "returning an injured employee back to productive work
while recovering promotes better and faster healing." Dr. Sanders believes that work provides enormous benefit to one's physical
and mental health. He further believes that nearly all injured employees are able to work at full or partial capacity - and limited
capacity provided that they are ambulatory by six weeks after an acute injury. This is especially true for cases of injuries to
intervertebral disks of the cervical and lumbar regions. Patients who undergo surgical laminectomy can return to their regular occupation
without restriction by four months. Those who undergo spinal fusion may return to their regular occupation by six months post procedure.
Dr. Sanders no longer adheres to the TWCC Advisory 2003-10 or 10B when he performs Impairment Evaluations. He has determined that
it does not carry the authority of Statute, and it has encouraged injured employees to undergo unnecessary spinal surgery, which
will nearly always leave them in worse condition.
Dr. Sanders believes that symptoms of Carpal Tunnel Syndrome or Ulna Nerve Entrapment at the elbow, which may be induced by excessive
use of the computer, are transient and will resolve when work stations are rotated. He further believes that in most cases, verifiable
Carpal Tunnel Syndrome, or Ulna Nerve Entrapment at the elbow, are related to diabetes, thyroid disease, rheumatoid arthritis, or
menopausal changes - and as such, are ordinary diseases of life and not occupational injuries or disease.
Dr. Sanders is on the ADL list and is a Level 2 Doctor. He has been a Designated Doctor since l998 and passed the TIRSAT in June
2003. He has offices in nearly every Texas city that has a Texas Workers' Compensation Commission (TWCC)
field office. He is available for referrals as a treating physician, as well as for Designated Doctor and Required Medical Examinations.
