DWD 81.08(3)(f)1.b.b. Maximum treatment frequency is up to 3 times per week for the first one to 3 weeks decreasing in frequency until the end of the maximum treatment duration period in subd. 1. c.

DWD 81.08(3)(f)1.c.c. Maximum treatment duration is 12 weeks in a clinical setting but only if used in conjunction with other therapies.

DWD 81.08(3)(f)2.2. Home use of a mechanical traction device may be prescribed as follow-up to use of traction in a clinical setting if it has proven to be effective treatment and is expected to continue to be effective treatment. Initial use of a mechanical traction device shall be in a supervised setting in order to ensure proper patient education. All of the following guidelines apply to home use of a mechanical traction device:

DWD 81.08(3)(f)2.b.b. A patient may use the mechanical traction device for one month, at which time effectiveness of the treatment shall be reevaluated by a health care provider before continuing home use of the device.

DWD 81.08(3)(g)(g) Acupuncture treatments. For purposes of this paragraph, “acupuncture treatments” include endorphin-mediated analgesic therapy that includes classic acupuncture and acupressure. All of the following guidelines apply to acupuncture treatments:

DWD 81.08(3)(g)2.2. Maximum treatment frequency is up to 3 times per week for one to 3 weeks and decreasing in frequency until the end of the maximum treatment duration period in subd. 3.

DWD 81.08(3)(h)(h) Manual therapy. For purposes of this paragraph, “manual therapy” includes soft tissue and joint mobilization, therapeutic massage, and manual traction. All of the following guidelines apply to manual therapy:

DWD 81.08(3)(h)2.2. Maximum treatment frequency is up to 5 times per week for the first one to 2 weeks decreasing in frequency until the end of the maximum treatment duration period in subd. 3.

DWD 81.08(3)(i)(i) Phoresis. For purposes of this paragraph, “phoresis” includes iontophoresis and phonophoresis. All of the following guidelines apply to phoresis:

DWD 81.08(3)(i)2.2. Maximum treatment frequency is up to 3 times per week for the first one to 3 weeks and decreasing in frequency until the end of the maximum treatment duration period in subd. 3.

DWD 81.08(3)(j)(j) Bedrest. Prolonged restriction of activity and immobilization are detrimental to a patient’s recovery. Bedrest may not be prescribed for more than 7 days.

DWD 81.08(3)(k)(k) Spinal braces and other movement restricting appliances. Spinal braces and other movement-restricting appliances required for longer than 2 weeks shall be accompanied by active muscle strengthening exercise to avoid deconditioning and prolonged disability. All of the following guidelines apply to spinal braces and other movement-restricting appliances:

DWD 81.08(3)(k)2.2. Maximum treatment frequency is limited to intermittent use during times of increased physical stress or prophylactic use at work.

DWD 81.08(4)(a)(a) Active treatment modalities shall be used as set forth in pars. (b) to (f). A health care provider’s use of active treatment modalities may extend past the 12-week limit on passive treatment modalities, so long as the maximum durations for the active treatment modalities are not exceeded.

DWD 81.08(4)(b)(b) Education shall teach the patient about pertinent anatomy and physiology as it relates to spinal function for the purpose of injury prevention. Education includes training on posture, biomechanics, and relaxation. The maximum number of treatments is 3 visits, which include an initial education and training session and 2 follow-up visits.

DWD 81.08(4)(c)(c) Posture and work method training shall instruct the patient in the proper performance of job activities. Topics include proper positioning of the trunk, back and arms, use of optimum biomechanics in performing job tasks, and appropriate pacing of activities. Methods may include didactic sessions, demonstrations, exercises, and simulated work tasks. The maximum number of treatments is 3 visits.

DWD 81.08(4)(d)(d) Worksite analysis and modification shall examine the patient’s work station, tools, and job duties. A health care provider may make recommendations for the alteration of the work station, selection of alternate tools, modification of job duties, and provision of adaptive equipment. The maximum number of treatments is 3 visits.

DWD 81.08(4)(e)(e) Exercise, which is important to the success of an initial nonsurgical treatment program and a return to normal activity, shall include active patient participation in activities designed to increase flexibility, strength, endurance, or muscle relaxation. Exercise shall, at least in part, be specifically aimed at the musculature of the thoracic spine. Aerobic exercise and extremity strengthening may be performed as adjunctive treatment but may not be the primary focus of the exercise program.