Better Treatment for Back Pain?

Chronic back pain is one of the issues that countless doctors and dentists face every day. Many of our clients have suffered from pain that doesn’t allow for effective practice, and thus have had to deal with the disability insurance claims process. According to the American Society of Anesthesiologists, there is a new treatment that could help alleviate some forms of back pain in certain patients. We’re going to be taking a look at the study they published regarding spinal cord stimulation (SCS), as well as answer some questions about SCS for those who don’t know about it.

The Study

This study compared the effectiveness of high frequency to traditional SCS therapy for back and leg pain. Researchers treated 90 patients with high frequency therapy while 81 received the traditional SCS. After three months, 85% of back pain patients, and 83% of leg pain patients reported a 50% or greater reduction in pain, while only 44% of back pain patients and 56% of leg pain patients in the traditional SCS group experienced a 50% reduction in pain.

Also, more patients (55% to 32%) in the high frequency group stated that they were “very satisfied” with their pain relief. Patients of the high frequency treatment didn’t experience any paresthesia, which is commonly associated with SCS.

SCS Questions

  1. What is SCS?

SCS is therapy that delivers low-level electrical signals to the spinal cord or to specific nerves in order to block pain signals from reaching the brain.

  1. How does SCS work?

A device is implanted in the back near the spinal cord through a needle and generator is placed through a small incision in the upper buttock. The patient is able to adjust the intensity of the signals or turn the current on or off.

  1. How does the SCS stay charged?

It depends on the device: some SCS systems have a pulse generator, which is like a battery, some have a rechargeable pulse generator system that can be charged through the skin, and others do not require recharging but last a shorter time before they need to be replaced.

  1. How much higher is the high frequency SCS?

The high frequency SCS pulses at 10,000 Hz, while traditional SCS has a frequency between 40 and 60 Hz.

  1. What is paresthesia?

Paresthesia is a sensation such as tingling or buzzing that is commonly associated with SCS. It is thought to potentially mask a patient’s perception of pain, and is often distracting or uncomfortable, thus limiting the effectiveness or desirability of SCS treatment.

  1. What are the risks of SCS?

SCS doesn’t address the source of the pain; it merely interrupts the pain signals sent to the brain from your body. If you have pain that stems from a correctable anatomical problem, it is probably best to look for treatment that will address this problem first. SCS also involves an implant and surgery, which naturally comes with risks and potential complications.

            These include:

  • Allergic reactions to the implanted material
  • Bleeding
  • Infection
  • Weakness, numbing, clumsiness, paralysis
  • Fluid lead from the spinal cord
  • Migration of the electrode
  1. What is this treatment called?

The treatment is being called HF10™.


This study is just the first step in a new treatment that could bring relief to people suffering from chronic pain. We encourage you to speak with your doctor before starting any sort of treatment.


Can Your iPhone Tell You if You are Depressed?

Smartphones are getting smarter, and the desire for convenience and streamlined administration is at an all-time high. We have taken a look at how Skype doctors could potentially influence your medical treatment, but what if your smartphone could predict depression without the help of a medical professional? A new app claims to be able to identify people who are at a higher risk for depression.

The Purple Robot

The “Purple Robot” is an app in development at Northwestern University. While it isn’t available to the public yet, the app was able to identify 87% of participants who were determined to be at risk of depression. How? By tracking GPS data that showed how much users moved between their regular locations. The more users moved, the less likely they were to be considered at-risk.

The Purple Robot also could detect 74% of higher-risk participants by figuring out who used their phone the most for texting, playing games, and checking social media. Talking on the phone more frequently, on the other hand, was not indicative of a greater chance of depression. Unfortunately, there wasn’t enough data, probably due to the small number of participants in the study, for researchers to determine the effectiveness of the app using both GPS and phone usage trends.

Pros and Cons?

Currently, this app only can tell you if you have an above-average chance of having depression and cannot diagnose it. While it certainly could help people to recognize if they need to see their doctor to discuss their potential depression, it could also potentially incorrectly identify you for being at risk. The test in the study used a low cutoff score, so it may have identified people for being at risk when they actually weren’t.

The Purple Robot is still in testing, and its developers at Northwestern University are planning on including more data, such as how long people talk on the phone and who they talk to, into the analysis. They are also encrypting the data, which provides some peace of mind for those who are concerned about data leaks.

Even if the app is changed to become more accurate, the GPS capabilities may be a turn-off for some people. Especially due to the hype surrounding multiple recent data hacks, having your GPS location at risk is definitely something to consider before using this app.


Since this app has not been revealed to the public, we don’t know quite what effect it would have on the disability insurance claims process. We do, however, recommend that you are cautious about the apps that you use that involve your health, especially if you think you may eventually have to file for disability.

We would also advise that you speak with your doctor if you think that you may be depressed. While these apps may assist you in realizing that you need to seek help, they aren’t yet able to substitute for diagnosis from a medical professional.


“Working Through Pain:
How Chronic Conditions Affect Dentists”

pretty dentist

Dentists are particularly at risk for disability due to the strenuous nature of their job.  Dentists are also some of the most likely to keep working through the pain–even if they shouldn’t be.  Our new article in Dentaltown Magazine explores how working through chronic pain can affect dentists in their personal and professional lives.  Read the full article at Dentaltown today.

“Working Through Pain: How Chronic Conditions Affect Dentists”


Are Longer Hours Hindering Your Ability to Work?


Long hours at work are typical of doctors: there is no break in people getting sick or having physical issues. But what does working long hours do physically and mentally to doctors, and how can this affect your practice? The term “overwork” refers to the increasing risk that a worker will experience symptoms of fatigue and work stress, which can undermine productivity rates. We’re going to be taking a look at some of the statistics involved with professionals working long hours and then discuss how this can not only hinder productivity in your practice, but can also affect your body and, in some cases, how soon you need to file a disability insurance claim.

Longer Hours

There numbers regarding the average work week for Americans, especially professionals such as doctors, show that most people expect to work extended hours. This is associated with the trend of “presenteeism” among doctors and dentists, which we have spent some time dissecting. In fact, many professionals now view the traditional 40-hour work week as a “part-time” job, and state that working those hours show laziness or a lack of desire to get ahead.

  • In 2006, American families worked an average of 11 hours more per week than they did in 1979.
  • 85.8% of males and 66.5% of women are working 40 or more hours per week. 1)See American Average Work Hours at 20Something Finance
  • 37.9% of professional men worked over 50 hours a week between 2006 and 2008, which is an increase from 34%.
  • The number of professional women working over 50 hours increased even more drastically, from 6.1% to 14.4% in the same time period. 2)See Top-Level Professionals View 40-Hour Work Week as Part-Time at The Huffington Post
  • 52% of top income earners in America report working “extreme jobs,” which are those that require more than 60 hours a week. 3)See Success Comes at a Steeper Price at ABC News

Effects of Overwork 4)See The Effects of Working Time on Productivity and Firm Performance

Studies have shown that working longer hours leads to a decrease in productivity per hour. Any doctor that has worked more than 10 hours a day, as they often do, can attest that the 9th hour is much more difficult to get through than the first. The evidence shows that longer working hours have a negative effect on worker health due to fatigue and work stress, all of which further decrease labor productivity.

Workers with long hours are at a greater risk of health issues. For instance, those who perform repetitive tasks have an even greater chance of cumulative trauma disorder, such as carpal tunnel syndrome. This shouldn’t be shocking to medical professionals, as many of the disabilities that they suffer come from repetitive use injuries. An interesting way to think of the way your hours affect your work is to think of your body using a minimum amount of energy for posture and immunity, which has a great effect on back and neck pain. If you draw too much on this energy for work, your posture and immunity will suffer.

As another example, working extended hours can have a negative effect on mental health. We have also discussed how medical professionals are more susceptible to mental illness. Studies have shown that working long hours leads to increased stress, which can contribute to the already stressful situations doctors face every day.

What Does This Mean for You?

One positive finding regarding hours worked and productivity is that those who have the flexibility to schedule their own hours are not only happier but more productive. Even more striking is the fact that even if workers had to put in overtime, if they chose this overtime themselves instead of being asked to do it by a supervisor, they were much more productive and less fatigued.

This is certainly good news for those medical professionals that own their own business and are able to schedule their time as they see fit. However, doctors such as residents or those working within another professional’s practice may feel pressured to take on more hours, and are also constrained by other doctors’ schedules. For these reasons, it’s important for the medical and dental community as a whole to take a better approach regarding long hours. While we certainly don’t presume to know what is most appropriate in terms of streamlining care and administration, it certainly seems logical that doctors be encouraged to work fewer hours or have more freedom in scheduling the hours that they are going to work.

Let us know what you think about working long hours and whether you have schedule flexibility in the comments!


References   [ + ]

1. See American Average Work Hours at 20Something Finance
2. See Top-Level Professionals View 40-Hour Work Week as Part-Time at The Huffington Post
3. See Success Comes at a Steeper Price at ABC News
4. See The Effects of Working Time on Productivity and Firm Performance

Could Your Tech Be Hurting You? : Skype Doctors

The third and final post of our series on insurance claims technology focuses on the recent development of digital healthcare. Our previous topics included Facebook and insurance company apps, and we analyzed how they can have a greater effect on your claim than you would think. You are now able to obtain a diagnosis and medication prescriptions via Skype. Just like the Hartford app, this is looking to streamline administrative processes and save people time. However, it is controversial in that many doctors believe that there are cases in which a physical examination is necessary, and webcam quality may not be enough to correctly diagnose a patient.

Diagnoses via Skype

It is touted as being quick and efficient; users need only to type in their symptoms and payment information and they will be connected with a doctor who can then call in a prescription as they see fit. While this is very convenient for people who are too busy or in too much pain to travel to and wait in a doctor’s office, it could also lead to a wrong diagnosis, which would almost assuredly use more time and money.

While there haven’t been any studies on how effective this form of treatment is, we advise disability insurance claimants to exercise caution when using these Skype calls. Because this technology is so new, there is little information on how disability insurance would approach Skype consultations in conjunction with a disability insurance claim.  An insurance company could potentially say that this information is unreliable, and use the alleged lack of reliable medical evidence to deny your claim. If you are facing a disability insurance claim, speak with an attorney experienced in the area before you use a Skype consultation as evidence of your condition.


While it is certainly helpful that many things are now available at our fingertips through the development of new technologies, it is important to keep in mind that giving more information than necessary to insurance companies may hurt your claim. Most people who file disability claims have nothing to hide, but it is the insurer’s job to make money, and paying every claim isn’t a good way to do this.

Did we miss any new technology? Let us know in the comments!


Unum is Making Some Changes, But Are They Good For Your Plan?

In previous posts, we have discussed how courts and juries have reprimanded Unum and its various subsidiaries for wrongfully denying disability claims.  Now, Unum is once again making the headlines—this time for making significant changes to its leadership at the highest levels of the company.

What’s changing?

Essentially, Unum is undertaking a widespread overhaul of its upper management.  Marco Forato is now the senior vice president for global growth strategy, Steve Mitchell is the new chief financial officer, and Steve Zabel is the new president of the U.S. closed block operations.  Additionally, Vicki Gordan has been promoted to senior vice president and chief internal auditor, and Matt Royal is now the chief risk officer for Unum.

While any change of leadership can have substantial ramifications, those insured by Unum should take particular note that Unum has appointed a new “president of the U.S. closed block operations.”  “Closed block” refers to Unum’s discontinued product lines, which, according to Unum’s 2014 Annual Report, include long-term care and older individual disability policies.  If you are a physician or dentist with a Unum policy, your policy is probably part of Unum’s “closed block” operations.

Unum’s new president of “closed block” operations will likely face a challenging task because any losses suffered from paying out Unum’s old disability policies cannot be offset by new business.  Additionally, such “closed block” operations are a relatively new phenomenon in the insurance industry, so there is a very small reserve of historical data for Unum to draw upon.

What does this mean?

Generally speaking, a company does not make such extensive changes without expecting results.  Consequently, it is likely that several, if not all, of Unum’s newly appointed leaders will be under substantial pressure to perform.  Because fresh leaders often want to leave their own mark on their industry, insureds should pay close attention to any new changes in policy announced by Unum during this transitional period.

More specifically, insureds with older individual disability policies with Unum should be aware that Unum will likely be looking for new, creative ways to deny their claims.  If you have such a policy and you feel that Unum has arbitrarily changed your policy’s terms and/or wrongfully denied your disability claim, you should consult with an experienced disability insurance attorney to ensure that Unum’s leadership is not improperly exceeding the scope of their newly acquired authority.


Posture and Your Practice

Good posture is important for everyone, but especially for dentists, who spend a fair amount of time in static positions, making repetitive movements, or bending or twisting in ways that aren’t necessarily natural for human bodies. Today, we’re going to give you some tips on how to improve your posture and positioning in your everyday life as well as your practice, so that you may potentially avoid or delay future disabling pain.

General Posture

  • Keep your body in alignment.
    • While standing, this means distributing your weight evenly on both feet, and making sure that you keep your weight from shifting either forward on the balls of your feet or backward on your heels.
    • When seated, sit up straight and keep your ears, shoulders, and hips in a straight line. A good trick is to picture a balloon attached to the top of your head, pulling you upward.
  • Move around a bit.
    • When your muscles get tired, it’s much easier to slouch or fall into a position that might be comfortable now, but could strain parts of your body you don’t want strained. It’s important to walk around after every half-hour or so of sitting to stretch and refresh your body.
    • Also, moving around slightly while seated is a good way to refresh your muscles. Instead of making your back tight by forcing a constantly straight position, bend a little bit every now and then to reset your posture, and give yourself a break.
  • When working at a desk, use a chair that has good lumbar support or use a small pillow placed between your back and the chair.
    • The spine naturally curves in an “S” shape, so it is important to support your lower back. Ergonomically designed chairs can do this. Using a small pillow for your lower back can also help support your spine.
    • It is also important to sit back in your chair and not on the edge of the seat. A chair is able to provide a solid foundation for your seat only if you use all of the area.
  • Make sure your desk chair is properly aligned to your workspace.
    • Keep your feet flat on the floor and have your hips slightly higher than your knees when sitting at a desk. This will keep you from adding strain to your hip flexor muscles, which play a role in lower back stability.

In the Dental Chair

  • Keep your patient at waist level.
    • This enables you to maintain your proper posture and work safely within your patient’s mouth. It also helps keep your wrists straight, and elbows at 90 degrees, which puts less strain on your arms, shoulders and back.
    • To test it out, hold a 5–pound weight away from your body at waist–height and slowly move it in until your elbows are at 90 degrees. Notice how the weight is much more comfortable to hold when it is closer to your body.
  • Have your tools easily available.
    • Keep everything you may need within a short reach and in front of you so you don’t do any unnecessary twisting, bending or turning.
  • Have better designed tools.
    • You can get lighter tools and angled hand-pieces that allow you to better reach difficult places in your patient’s mouth. It would also be helpful to replace old hoses with ones that are designed to be lighter and straight, so you don’t have to fight the tension of a coil.
    • Gloves are also important: using ambidextrous gloves forces your thumb into an unnatural position and constrains your fingers into one plane, which isn’t anatomically correct. Look into purchasing gloves specifically for your left and right hands to avoid this strain.

While all of these tips can be helpful in preventing future pain, none of them are a cure-all for potential disabilities, and they may not “fix” pain that has already begun. It is essential to have a dialogue with your doctor about any issues that you may be having. It may also be useful to talk to a disability insurance lawyer if you think that your current or future pain may not allow you to continue practicing. We hope that these tips were helpful; let us know in the comments what worked for you!