Medical Treatment Options for Lumbar and Cervical Injuries in Texas Workers’ Compensation
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Medical Treatment Options for Lumbar and Cervical Injuries in Texas Workers’ Compensation
Lumbar (lower back) and cervical (upper spine) injuries are among the most common and most disabling injuries in Texas workers’ compensation claims. These injuries often require extensive medical care, imaging, specialist referrals, and sometimes surgery.
But Texas workers’ compensation does not make treatment easy.
Insurance companies frequently delay or deny care using utilization review, peer review doctors, and designated doctor opinions to limit treatment.
This guide explains the available types of medical treatment options for lumbar and cervical injuries in Texas workers’ comp, how treatment is approved, and what injured workers must know to protect their rights.
How Medical Treatment Works in Texas Workers’ Compensation
All medical care must be:
- Reasonably required
- Related to the compensable injury
- Consistent with the Official Disability Guidelines (ODG), or preauthorized
Carriers often deny treatment by claiming it is:
- Not medically necessary
- Not related to the work injury
- Outside ODG recommendations
- Unsupported by objective findings
This is why strong medical documentation — and legal representation — is essential.
Types of Medical Treatment for Lumbar and Cervical Injuries
Below is a comprehensive overview of the treatment options typically available for lumbar and cervical spine injuries in Texas workers’ compensation.
1. Initial Evaluation and Conservative Care
Most injured workers begin with conservative treatment, including:
- Anti‑inflammatory medications
- Muscle relaxers
- Pain medication
- Rest and activity modification
- Work restrictions or light duty
Conservative care is often required before advanced treatment is approved.
2. Physical Therapy (PT)
Physical therapy is one of the most common treatments for both lumbar and cervical injuries. PT may include:
- Strengthening exercises
- Stretching
- Manual therapy
- Traction
- Posture and body‑mechanics training
- Home exercise programs
Carriers often limit PT to a set number of sessions unless the doctor provides strong justification.
3. Chiropractic Care
Chiropractic treatment may be approved for:
- Lumbar strains
- Cervical strains
- Disc injuries
- Radiculopathy
- Muscle spasms
These services are often paired with PT or used as an alternative conservative treatment.
4. Diagnostic Imaging
Imaging is critical for diagnosing lumbar and cervical injuries.
X‑Rays
Used to rule out fractures or alignment issues.
MRI (Magnetic Resonance Imaging)
The gold standard for identifying:
- Herniated discs
- Bulging discs
- Annular tears
- Nerve compression
- Spinal stenosis
- Facet joint injuries
CT Scans
Used when MRI is not possible or when bone detail is needed.
EMG/NCS Testing
Confirms radiculopathy or nerve damage.
Carriers frequently deny MRIs using peer review doctors — even when clearly necessary.
5. Pain Management
Pain management may include:
- Epidural steroid injections (ESIs)
- Facet joint injections
- Medial branch blocks
- Radiofrequency ablation (RFA)
- Trigger point injections
- Medication management
These treatments are often necessary for workers with disc herniations, radiculopathy, or chronic pain.
6. Specialist Referrals
Workers with lumbar or cervical injuries may be referred to:
- Orthopedic spine surgeons
- Neurosurgeons
- Pain management specialists
- Neurologists
Carriers often delay or deny specialist referrals unless the treating doctor provides strong justification.
7. Surgery
Surgery may be required for severe lumbar or cervical injuries, including:
Lumbar Surgeries
- Discectomy
- Laminectomy
- Microdiscectomy
- Spinal fusion
- Artificial disc replacement
Cervical Surgeries
- Anterior cervical discectomy and fusion (ACDF)
- Posterior cervical fusion
- Cervical disc replacement
- Foraminotomy
Surgery is typically approved only after conservative care fails — unless the injury is catastrophic.
8. Post Surgical Rehabilitation
After lumbar or cervical surgery, workers may require:
- Physical therapy
- Pain management
- Work‑hardening programs
- Functional capacity evaluations (FCEs)
Rehabilitation is essential for restoring strength and mobility.
9. Durable Medical Equipment (DME)
Workers may receive:
- Back braces
- Cervical collars
- TENS units
- Home traction devices
- Ergonomic supports
These devices help stabilize the spine and reduce pain.
10. Long Term Care for Chronic Conditions
Some lumbar and cervical injuries result in chronic pain or permanent limitations. Long‑term care may include:
- Ongoing pain management
- Maintenance physical therapy
- Medication management
- Repeat injections
- Psychological support for chronic pain
Workers with severe impairment may qualify for Supplemental Income Benefits or, in rare cases, Lifetime Income Benefits.
How Insurance Companies Limit or Deny Treatment
Carriers frequently deny treatment by using:
- Peer review doctors
- Utilization review (UR)
- Designated doctor opinions
- Extent‑of‑injury disputes
- ODG guideline limitations
They may claim:
- The injury is degenerative
- The treatment is excessive
- The condition is pre‑existing
- The treatment is not medically necessary
- The injury is not part of the compensable diagnosis
This is why injured workers must be prepared for designated doctor exams and understand how to challenge denials.
How MLF Legal Helps Injured Workers Get the Treatment They Need
Our Workers’ Compensation Lawyers assist clients by:
- Ensuring the lumbar or cervical injury is fully accepted
- Challenging extent‑of‑injury denials
- Fighting for MRI approval
- Securing specialist referrals
- Challenging UR and peer review denials
- Preparing workers for designated doctor exams
- Ensuring post‑surgical care is authorized
- Protecting impairment ratings and income benefits
When treatment is delayed or denied, we take the fight to the DWC.
The Bottom Line
Lumbar and cervical injuries often require extensive medical treatment — but Texas workers’ compensation makes obtaining that care difficult. Insurance companies deny MRIs, specialist referrals, injections, and surgery every day.
If you suffered a lumbar or cervical injury at work, you need a lawyer who understands the medical issues, the legal standards, and the strategies necessary to secure the treatment you deserve.
MLF Legal handles real Texas workers’ compensation cases through the full DWC process — including treatment denials, extent‑of‑injury disputes, and impairment rating challenges.
Call MLF Legal - FREE Consults
If your lumbar or cervical injury treatment is being delayed or denied, call MLF Legal today.
📞 214‑357‑1782
We fight for injured workers — not insurance companies.
FAQs: Medical Treatment Options for Lumbar and Cervical Injuries in Texas Workers’ Compensation
Injured workers may receive a wide range of treatment, including physical therapy, chiropractic care, pain management injections, diagnostic imaging (MRI, CT, EMG), specialist referrals, surgery, and post‑surgical rehabilitation. Treatment must be reasonably required and related to the compensable injury.
Yes — MRIs are often essential for diagnosing disc herniations, bulges, stenosis, and nerve compression. However, carriers frequently deny MRI requests using peer review doctors. Learn more at What Is a Peer Review Doctor?.
Yes. Workers may be referred to orthopedic spine surgeons, neurosurgeons, neurologists, or pain management specialists. Carriers often delay or deny specialist referrals unless the treating doctor provides strong justification.
- Anti‑inflammatory medications
- Muscle relaxers
- Physical therapy
- Chiropractic care
- Work restrictions
Yes. Epidural steroid injections, facet injections, medial branch blocks, and radiofrequency ablation (RFA) are commonly approved when conservative care fails. These treatments are especially helpful for radiculopathy and chronic pain.
Yes — if surgery is medically necessary and related to the compensable injury. Common surgeries include lumbar discectomy, laminectomy, fusion, and cervical ACDF or disc replacement. Surgery is usually approved only after conservative care fails unless the injury is catastrophic.
- Utilization review appeals
- A treating doctor’s rebuttal
- A designated doctor exam
- A Benefit Review Conference (BRC)
- A Contested Case Hearing (CCH)
Yes. Injured workers may receive back braces, cervical collars, TENS units, traction devices, and ergonomic supports when medically necessary.
Yes. Most lumbar and cervical injuries — especially those involving disc herniations, radiculopathy, or surgery — result in an Impairment Rating (IR). The IR determines how long Impairment Income Benefits (IIBs) last and whether the worker qualifies for SIBs. Learn more at How to Dispute an Impairment Rating in Texas.
Yes — but the doctor must be on the Texas workers’ compensation network (if your employer uses one). Choosing the right doctor is critical because they control your treatment plan, referrals, and impairment rating.
Yes. These injuries are among the most frequently disputed in Texas workers’ comp. A lawyer can fight for MRIs, specialist referrals, injections, surgery, and proper impairment ratings.
Injured at work in Texas and your employer doesn’t have workers’ comp?
You may have the right to sue and recover full compensation.
Contact MLF Legal today for a free consultation. You pay nothing unless we win your case.
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