Caring for Your Cast or Splint After a Work Injury

Casts and splints are used to immobilize or to support a part of the body to aid in healing.  Casts and splints can also help to reduce muscle spasms, pain and swelling and are typically made of fiberglass or a plaster material.  Your medical provider will decide which material and type of cast or split is suited for your particular needs and custom fit it your body.

It is very important for your healing process to keep your cast or splint in good condition.  I found these tips from to help guide you on caring for your splint or cast.


Keep your splint or cast dry. Moisture weakens plaster and damp padding next to the skin can cause irritation. Use two layers of plastic or purchase waterproof shields to keep your splint or cast dry while you shower or bathe.

Walking casts. Do not walk on a “walking cast” until it is completely dry and hard. It takes about one hour for fiberglass, and two to three days for plaster to become hard enough to walk on.

Avoid dirt. Keep dirt, sand, and powder away from the inside of your splint or cast.

Padding. Do not pull out the padding from your splint or cast.

Itching. Do not stick objects such as coat hangers inside the splint or cast to scratch itching skin. Do not apply powders or deodorants to itching skin. If itching persists, contact your doctor.

Trimming. Do not break off rough edges of the cast or trim the cast before asking your doctor.

Skin. Inspect the skin around the cast. If your skin becomes red or raw around the cast, contact your doctor.

Inspect the cast regularly. If it becomes cracked or develops soft spots, contact your doctor’s office.


If you are having any issues with your cast or splint, it is always best to consult your doctor before attempting to handle it on your own.  Also, if you are working while you are in a cast or splint, make sure to get clear concise instructions from your doctor as to what limitations you are under, you may need to explain to him or her in great detail what is expected of you at work so that your restrictions can be written appropriately.

If you or a loved one have suffered a work related injury, order my book, “The Ultimate Guide to Workers’ Compensation in Virginia” by clicking this link, or call our office today (804) 755-7755.


Michele Lewane, Esq.


Coping with Back Pain & Depression After a Work Injury

I found a great article today ( on dealing with chronic pain and depression.  Sadly many injured workers who have suffered a serious injury can end up dealing with one or both of these conditions.  I wanted to pass along Dr. Deardorff’s article in hopes that this information may help some of my clients dealing with these adverse situations.


As always, this is not intended as medical advice, simply information to keep my clients well informed and hopefully help them to address these issues with their doctor.


4 Tips to Help Cope With Chronic Pain and Depression

By: William W. Deardorff, PhD, ABPP

It is not uncommon for those who suffer from chronic pain to feel stressed and depressed at times. This is no surprise, given the fact that “chronic pain” usually means pain that lasts more than three to six months. Prolonged pain appears to set up a pathway in the nervous system that sends pain signals to the brain, even in the absence of an underlying anatomical problem.


Some chronic pain may be due to a diagnosable anatomical problem, such as degenerative disc disease or spinal stenosis, that can cause continual pain until successfully treated. More often, the chronic pain has no clear anatomical cause, as in failed back surgery syndrome or chronic back pain without an identified pain generator. In such cases, the pain is itself the disease. Click here for more Depression Symptoms


For some people, the stress and depression resulting from chronic pain can become consuming, and can even worsen and prolong the pain. Increased pain can, in turn, lead to increased stress and depression, creating a cycle of depression and pain that can be difficult to break. There are things a person with pain can do, however, to prevent or manage the chronic pain and depression that may develop:


1) Minimize the chances of developing chronic pain

Talking to a physician about symptoms of depression or stress, or a history of depression, while still in the acute pain phase can alert a physician to the need for consideration of both conditions in creating a treatment plan for the patient’s spine health. While one patient may demonstrate a full recovery from the initial injury, a patient who is more prone to depression and stress, shows signs of depression and/or stress, or who has a history of clinical depression may be more vulnerable to developing a chronic pain problem that persists beyond the initial acute pain complaint. An informed physician can suggest a treatment plan early on that treats the patient’s mental state as well as their physical pain, minimizing the chances of the patient developing a chronic pain problem.


It is advisable for patients to talk with their doctors if they experience any of the following common symptoms of depression:

*Changes in sleep patterns

*Changes in appetite

*Feelings of anxiety.


Stress can manifest itself in several ways Patients should talk with their doctors if they believe they exhibit symptoms characteristic of stress-related back pain, which are similar to those of fibromyalgia:


*Back pain and/or neck pain

*Diffuse muscle aches

*Muscle tender points

*Sleep disturbance and fatigue

*In many stress-related back pain cases, patients complain of the pain “moving around”


Chronic pain can also be exacerbated by things such as physical de-conditioning due to lack of exercise and a person’s thoughts about the pain. Patients can help thwart their pain from developing into or minimizing chronic pain by engaging in an appropriate exercise program and practicing distraction, guided imagery and other cognitive techniques.


2) Identify stress triggers that can increase chronic pain

“Patients can monitor how their own stress and anxiety affects their back pain by keeping a diary of when their back pain changes and what kinds of stress could be triggering the pain. This exercise can redirect a patient’s focus from the pain to the elements in their life that affect their pain. Identifying stress triggers or emotional triggers that affect the pain will give the patient the opportunity for better pain relief through avoiding or eliminating these stress triggers. Recognizing how depression and stress affect their pain can lessen anxiety by giving patients more control over their chronic pain problem.”


3) Communicate about depression

“Depression and an emotional reaction to chronic pain are normal. Many patients do not speak to their physicians about their depression because they believe that once the initial pain problem is resolved, the depression, anxiety, and stress they are feeling will go away. However, secondary losses from a chronic pain problem, such as changes in the ability to do favorite activities, disrupted family relationships, financial stress, or the loss of a job, can continue to contribute to feelings of hopelessness and depression.


“Talking to a physician about feelings of depression will keep the physician better informed and better able to provide appropriate care. Depression can affect the frequency and intensity of pain symptoms, and the healing rate. Getting simultaneous back pain treatment and depression treatment will give the patient a better chance of a full recovery.””


4) Seek multi-disciplinary care for pain and depression

“Informing a physician of depression can create an opportunity for a multi-disciplinary course of treatment involving both a physician and a mental health professional. With a team approach, both the pain problem and the depression are monitored simultaneously, and both doctors can communicate about how each area affects the other. It’s important for physicians to understand that changes in the physical symptoms of pain can also be related to changes in a patient’s mental state.


In addition, some common treatments for pain, including opioid pain medication, can actually make depression worse. This worsening depression can then affect the physical presentation of the pain. If both physical and mental well-being are being monitored closely by medical experts, treatment and medication recommendations, including antidepressants, can be made that take both the physical pain and the emotional health of the patient into account.”


For more information on Virginia Workers Compensation, order my book, “The Ultimate Guide to Workers’ Compensation in Virginia” by clicking this link, or call our office today (804) 755-7755.


Michele Lewane, Esq.

Depression and Chronic Back Pain After a Work Injury

I have represented a lot of injured workers who suffered a back injury at work and sometimes, these injuries can lead to other conditions, like depression or chronic pain.  While depression and chronic pain are very common after a serious back injury, there is still a lot that medical professionals are examining to better understand the relationship between chronic pain and depression.


I wanted to pass on Dr. Deardorff’s article (taken from explaining some of the links between chronic pain and depression so you can be informed and possibly have a better understanding of some things you might be dealing with.


Depression and Chronic Back Pain

By: William W. Deardorff, PhD, ABPP

“Depression is by far the most common emotion associated with chronic back pain. The type of depression that often accompanies chronic pain is referred to as major depression or clinical depression. This type of depression goes beyond what would be considered normal sadness or feeling “down for a few days”.


The symptoms of a major depression occur daily for at least two weeks and include at least 5 of the following (DSM-IV, 1994):


*A predominant mood that is depressed, sad, blue, hopeless, low, or irritable, which may include periodic crying spells

*Poor appetite or significant weight loss or increased appetite or weight gain

*Sleep problem of either too much (hypersomnia) or too little (hyposomnia) sleep

*Feeling agitated (restless) or sluggish (low energy or fatigue)

*Loss of interest or pleasure in usual activities

*Decreased sex drive

*Feeling of worthlessness and/or guilt

*Problems with concentration or memory

*Thoughts of death, suicide, or wishing to be dead


Chronic pain and depression are two of the most common health problems that health professionals encounter, yet only a handful of studies have investigated the relationship between these conditions in the general population (Currie and Wang, 2004).


Major depression is thought to be four times greater in people with chronic back pain than in the general population (Sullivan, Reesor, Mikail & Fisher, 1992). In research studies on depression in chronic low back pain patients seeking treatment at pain clinics, prevalence rates are even higher. 32 to 82 percent of patients show some type of depression or depressive problem, with an average of 62 percent (Sinel, Deardorff & Goldstein, 1996). In a recent study it was found that the rate of major depression increased in a linear fashion with greater pain severity (Currie and Wang, 2004). It was also found that the combination of chronic back pain and depression was associated with greater disability than either depression or chronic back pain alone.”


Depression is Common for Those with Chronic Back Pain

“Depression is more commonly seen in patients with chronic back pain problems than in patients with pain that is of an acute, short-term nature. How does depression develop in these cases? This can be understood by looking at the host of symptoms often experienced by the person with chronic back pain or other spine-related pain.


*The pain often makes it difficult to sleep, leading to fatigue and irritability during the day.

*Then, during the day, because patients with back pain have difficulty with most movement they often move slowly and carefully, spending most of their time at home away from others. This leads to social isolation and a lack of enjoyable activities.

*Due to the inability to work, there may also be financial difficulties that begin to impact the entire family.

*Beyond the pain itself, there may be gastrointestinal distress caused by anti-inflammatory medication and a general feeling of mental dullness from the pain medications.

*The pain is distracting, leading to memory and concentration difficulties.

*Sexual activity is often the last thing on the person’s mind and this causes more stress in the patient’s relationships.


Understandably, these symptoms accompanying chronic back pain or neck pain may lead to feelings of despair, hopelessness and other symptoms of a major depression or clinical depression.


A recent study by Strunin and Boden (2004) investigated the family consequences of chronic back pain. Patients reported a wide range of limitations on family and social roles including: physical limitation that hampered patients’ ability to do household chores, take care of the children, and engage in leisure activities with their spouses. Spouses and children often took over family responsibilities once carried out by the individual with back pain. These changes in the family often led to depression and anger among the back pain patients and to stress and strain in family relationships.”


I believe that depression can be a “silent destroyer” because too many people fail to recognize the signs or, they fail to get treatment for their condition even if the depression seems to be slowly breaking down the fabric of their lives.  I don’t want to see anyone suffer needlessly, there is help available.


While I NEVER give medical advice or a medical opinion, if you feel that the information in this article reflects on your situation, you need to address this with your doctor right away.


For more information on Virginia Workers Compensation, order my book, “The Ultimate Guide to Workers’ Compensation in Virginia” by clicking this link, or call our office today (804) 755-7755.


Michele Lewane, Esq.


Signs of Depression After a Work Injury

Many people who have suffered the misfortune of a workplace injury face the prospect of being out for work for an extended period of time. Being out of work for a long period of time can lead to other challenges (loss of income, lack of physical activity, inability to pay bills, prolonged periods of pain, anxiety, and so on). One of the big problems injured workers in these situations face is the increased likely hood that they could become depressed.

I have done some research on the internet and found several lists of signs to look for if you believe you or someone you know might be depressed. The first list is taken from the National Institute of Mental Health ( and the second list is taken from The Mayo Clinic (

I wanted to pass this information on to you so that you can hopefully recognize when you or someone you know may need help.

Signs and symptoms include: (
*Persistent sad, anxious, or “empty” feelings
*Feelings of hopelessness or pessimism
*Feelings of guilt, worthlessness, or helplessness
*Irritability, restlessness
*Loss of interest in activities or hobbies once pleasurable, including sex
*Fatigue and decreased energy
*Difficulty concentrating, remembering details, and making decisions
*Insomnia, early-morning wakefulness, or excessive sleeping
*Overeating, or appetite loss
*Thoughts of suicide, suicide attempts
*Aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment.

Depression symptoms include: (
*Feelings of sadness or unhappiness
*Irritability or frustration, even over small matters
*Loss of interest or pleasure in normal activities
*Reduced sex drive
*Insomnia or excessive sleeping
*Changes in appetite — depression often causes decreased appetite and weight loss, but in some people it causes increased cravings for food and weight gain
*Agitation or restlessness — for example, pacing, hand-wringing or an *inability to sit still
*Irritability or angry outbursts
*Slowed thinking, speaking or body movements
*Indecisiveness, distractibility and decreased concentration
*Fatigue, tiredness and loss of energy — even small tasks may seem to require a lot of effort
*Feelings of worthlessness or guilt, fixating on past failures or blaming yourself when things aren’t going right
*Trouble thinking, concentrating, making decisions and remembering things
*Frequent thoughts of death, dying or suicide
*Crying spells for no apparent reason
*Unexplained physical problems, such as back pain or headaches

For some people, depression symptoms are so severe that it’s obvious something isn’t right. Other people feel generally miserable or unhappy without really knowing why.

Depression affects each person in different ways, so symptoms caused by depression vary from person to person. Inherited traits, age, gender and cultural background all play a role in how depression may affect you

If you are dealing with depression related to your work injury, make sure you discuss this information with your doctor.

For more information on work injuries and Virginia Workers Compensation, order my book, “The Ultimate Guide to Workers’ Compensation in Virginia” by clicking this link, or call our office today (804) 755-7755.
Michele Lewane, Esq.

Types of Pain After a Work Injury

Injured workers dealing with pain need to education themselves on the different types of pain in order to have meaningful conversations with their doctors.; sometimes getting the information that you need is all a matter of asking the right questions.  I wanted to share these definitions with you so that you can have more information on the difference between normal pain and when there may be something more going on.

“What is pain? The International Association for the Study of Pain defines it as: An unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.”  (Taken from


Acute pain, for the most part, results from disease, inflammation, or injury to tissues. This type of pain generally comes on suddenly, for example, after trauma or surgery, and may be accompanied by anxiety or emotional distress. The cause of acute pain can usually be diagnosed and treated, and the pain is self-limiting, that is, it is confined to a given period of time and severity. In some rare instances, it can become chronic.”  (Taken from


Chronic pain is pain that has lasted for a long time. In medicine, the distinction between acute and chronic pain has traditionally been determined by an arbitrary interval of time since onset; the two most commonly used markers being 3 months and 6 months since onset,[1] though some theorists and researchers have placed the transition from acute to chronic pain at 12 months.[2] Others apply acute to pain that lasts less than 30 days, chronic to pain of more than six months duration, and subacute to pain that lasts from one to six months.[3] A popular alternative definition of chronic pain, involving no arbitrarily fixed durations is “pain that extends beyond the expected period of healing.”[1]

(Taken from



Again folks, this is in no way medical advice or a medical opinion.  If you are experiencing pain or chronic pain, you need to address this issue with your physician.


If you are dealing with ongoing pain as a result of a work injury, or for more information on Virginia Workers Compensation, order my book, The Ultimate Guide to Workers’ Compensation in Virginia” by clicking this link, or call our office today (804) 755-7755.


Michele Lewane, Esq.

Leg Pain & Numbness

I have several injured workers’ call my office and tell me that shortly after a back injury, they start to have pain, numbness or tingling in their leg or legs. While some folks that I talk to only have a mild discomfort, other people experience very extreme pain and other symptoms.
I wanted to share with you this article by Dr. Cooper highlighting some of the types of leg pain that can often times accompany a back injury. Read over Dr. Cooper’s article and if any of this information describes you, you need to bring this information to your doctor’s attention immediately. Remember for Virginia Workers’ Compensation, consistency is key so any time you experience a new issue (like the onset of leg pain) it needs to reported to the workers’ comp doctor right away.
This is not medical advice, only information for you to review and if appropriate, discuss with your doctor.

Leg Pain and Numbness: What Might These Symptoms Mean?
By: Grant Cooper, MD (taken from
“Leg pain can range from a mild nuisance that comes and goes, to debilitating pain that makes it difficult to sleep, to walk or engage in simple everyday activities. The pain can take many different forms – some patients describe the pain as aching, searing, throbbing, or burning, and it can be accompanied by other symptoms, such as a pins-and-needles sensation, and/or leg or foot numbness or weakness.
Leg pain may be caused by a problem in the leg, but often it starts with a problem in the lower back, where the sciatic nerve originates, and then travels along the path of the nerve (called sciatica).
For this reason, diagnosis of anyone with leg pain, foot pain, and/or leg or ankle or foot weakness or numbness, should include an examination of the lower back.
Leg Pain Symptoms and Descriptions
Not all leg pain derived from low back problems presents the same way. Leg pain caused by a low back problem is often accompanied by additional symptoms, such as leg numbness or weakness, or foot pain, and the type of leg pain experienced may vary widely from patient to patient.
Some typical descriptions of leg pain and accompanying symptoms include:
• Burning pain. Some leg pain sufferers experience a searing pain that at times radiates from the low back or buttocks down the leg, while others complain of intermittent pain that shoots from the lower back down the leg and occasionally into the foot. Words that patients use to describe this type of burning leg pain include radiating, electric or shooting pain that literally feels like a jolt. Unlike many forms of low back pain that can often be a dull ache, for many, leg pain can be excruciating and nearly intolerable. This type of burning pain is fairly typical when a nerve root in the lower spine is irritated, and it is often referred to as sciatica.
Practical point
Many low back disorders can cause pain to radiate, or be referred to, the leg and/or foot, so an accurate diagnosis of leg pain or foot pain should include a low back examination.
• Leg numbness or tingling. Anyone who has had a leg or foot ‘fall asleep’ and then gradually return to normal can imagine what numbness in a leg would feel like. Not being able to feel pressure, or hot or cold, is unnerving. Unlike the short-lived numbness of an asleep limb, numbness coming from a low back problem can be nearly continuous and can severely affect a person’s quality of life. For example, it can be difficult or almost impossible to walk or drive a car if one’s leg or foot is numb. Typical symptoms can range from a slight tingling sensation to complete numbness down the leg and into the foot.
• Weakness (foot drop) or heaviness. Here, the predominant complaint is that leg weakness or heaviness interferes significantly with movement. People have described a feeling of having to drag their lower leg and foot or being unable to move their leg as quickly and easily as needed while walking or climbing stairs, for example, because of perceived weakness or slow reaction. Patients with foot drop are unable to walk on their heels, flex their ankle, or walk with the usual heel-toe pattern.
• Constant pain. This type of pain is normally felt in the buttock area, so it is not technically leg pain but it may accompany some form of pain felt in the legs. It may also be pain that occasionally radiates past the buttock into the leg. This type of pain is usually described as “nerve pain,” versus an aching or throbbing pain. It is typically present only on one side, and is commonly called sciatica or lumbar radiculopathy. It may often be relieved by stretching, walking or other gentle movement.
• Positional leg pain. If leg pain dramatically worsens in intensity when sitting, standing or walking, this can indicate a problem with a specific part of the anatomy in the low back. Finding more comfortable positions is usually possible to alleviate the pain. For example, bending over may relieve pain from spinal stenosis, while twisting (as in a golf swing) can increase facet joint related groin, hip and leg ache.”

For more information on dealing with work injuries and Virginia Workers Compensation, order my book, “The Ultimate Guide to Workers’ Compensation in Virginia” by clicking this link, or call our office today (804) 755-7755.
Michele Lewane, Esq.

An injured worker cannot sue his employer, but there may be a negligent 3rd party.

May 16, 2011 by · Comments Off
Filed under: Claims Compensation, Personal Injury, truck accidents 

The biggest sum for an individual would come from what is called a third-party personal injury claim.  An injured worker cannot sue his employer.  He can only file a workers’ compensation claim against his employer.  However, there may be a “3rd” person who was negligent, causing your injury.  Here are some examples:  A medical malpractice claim against the treating physician, a personal injury claim against a non‑coworker for an auto accident, equipment maintenance, delivery of materials, or premise liability.  Another type is products liability, which would be a claim against a manufacturer for defective equipment.  If you believe there may be a possibility that the equipment that you were using (such as a forklift or a table saw) was defective, it is important to preserve that evidence by taking pictures or, ideally, keeping the equipment so it cannot be destroyed and an expert can look at it.  The reason these types of cases are “better” than a workers’ compensation case is because you can get money for pain and suffering.  As you recall, you can only get a portion of lost wages up to 9 ½ years and medical benefits under workers’ compensation.  This is not enough if you have a significant life-changing injury where you may never be able to go back to your career.  You may have permanent disabilities and, physically, cannot do various daily living activities that you used to do.  These are not compensated under workers’ compensation; however, in the other types of third party claims, you can get what is called pain and suffering and you would be able to be compensated for those types of losses.

If you’ve been hit by an uninsured motorist

October 1, 2010 by · Comments Off
Filed under: Death Benefits, truck accidents, Work Accident in Virginia 

Every state has a legal requirement for all drivers to carry liability auto insurance. This law is meant to protect those injured by other drivers reckless behavior, but as a Workers Compensation attorney and Personal Injury lawyer I am always encountering people that end up in a sad situation when the law ends up being inadequate. When a driver hits you there is a 1 in 6 chance they are not carrying auto insurance- leaving you dealing with the damage to your car and any medical bills you incur.

Just recently a Washington auto accident involving an uninsured driver has landed an elderly man and his family in a significant amount of debt. 90-year-old, Henry Oslund, was walking in a local 7-11 parking lot when he was hit by an SUV. The initial impact knocked Oslund to the ground where he was then run over once in reverse, and then again when the driver moved forward. Oslund was quickly taken to Harborview Medical Center with critical injuries.

Because the accident occurred on private property the driver was able to leave the scene without so much as a ticket in spite of the fact that he was driving without auto insurance. What’s worse is the driver had been cited for driving uninsured on two prior occasions and was still able to leave the scene and return home.

Because this driver was uninsured Henry Oslund and his wife now are faced with massive medical bills from Oslunds extensive stay in ICU and his 5 required surgeries. To save yourself from this type of disaster I strongly suggest you review your auto insurance policy and make sure your under-insured and uninsured motorist insurance. Protect yourself and your family from uninsured motorists so you will not face the same financial hardship as the Oslund family. Seattle car accident lawyer, Jason Epstein, has a short video discussing how uninsured motorist insurance can help you and what level of coverage you need to protect yourself. This video can be seen through the above link.

If you have been injured in a car accident do not wait to contact an attorney. For those located in the Virginia area contact my Injured Workers’ Law Firm for a free consultation. Or, if you are in the greater Seattle area contact the Seattle car accident law firm, Premier Law Group.

Steps Injured workers should do if you are released to light duty

If you are released to light duty, you must immediately register with the Virginia Employment Commission.  You are also required to look for light duty employment within your doctor’s restrictions.  You will need to file applications for employment with a minimum of two (2) potential employers each week, keeping a written record of the names of the business, the date of contact, and the type of position for which you applied.

TWO Mistakes People Make When Dealing With Doctors After An Injury

1. Failing to Seek Immediate Medical Attention After a Traumatic Event The victim is always responsible for proving that he or she was injured in a work accident. Insurance companies often believe that if you aren’t hurt badly enough to  immediately report your accident to your employer and seek immediate medical attention, you aren’t hurt badly enough to deserve compensation. Don’t ignore signs of pain, even small ones. See a doctor as soon as possible, as minor injuries can always get worse.

2.  Failing to Fully Disclose Your Health History and Habits to Your Doctor

A health care provider will usually ask if you had any injury or sickness before your current problem. It is important to be honest when answering this type of question. Doctors use past medical history to diagnose and treat you. Providing incomplete information can impact the quality of the medical care you receive. Concealing prior injury or sickness from your doctor will also hurt your legal case. If you provide your doctors with incomplete information, their medical opinions could be rejected by insurance companies and the Virginia Workers Compensation Commission. Aggravations of pre-existing injuries are covered under workers compensation.

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