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TOPLINE:

From 2016 to 2022, 5.3% of all US emergency department (ED) visits were for low back pain, with opioid prescribing declining and radiograph use remaining high.

METHODOLOGY:

• Researchers conducted a cross-sectional study using data from the National Hospital Ambulatory Medical Care Survey between 2016 and 2022.
• They analyzed 6522 ED visits for low back pain (mean patient age, 45.4 years; 60.3% women; 56.4% non-Hispanic White). From 2016 to 2022, an estimated 52.8 million weighted ED visits for low back pain occurred in the United States, accounting for 5.3% of the 991.7 million weighted total ED visits during that period.
• Primary outcomes were usual diagnostic and therapeutic care for low back pain.

TAKEAWAY:

• The mean pain score for ED visits was 7.2 out of 10.
• Opioid administration decreased from 35.0% in 2016 to 24.5% in 2022, and prescriptions declined from 32.5% to 13.5%.
• Radiographs were obtained in 39.4% of visits, and CT and MRI were used in 5.4% and 3.2% of visits, respectively.
• Both opioid prescribing and radiograph usage were highest among patients aged 75 years or older.

IN PRACTICE:

"From 2016 to 2022, an estimated 1 in 20 US ED visits were for a back pain-related reason, with a declining prevalence of opioid prescribing and a relatively stable prevalence of plain radiography use over the study period," the authors wrote.

SOURCE:

The study was led by Anuva Fellner, MPH, Northwestern University Feinberg School of Medicine, Chicago. It was published online on July 12, 2025, in Annals of Emergency Medicine.

LIMITATIONS:

This retrospective study relied on administrative data, possibly introducing misclassification bias due to variable data quality across sites. Results may not capture clinical nuances or reflect current practices beyond 2022.

DISCLOSURES:

This study was supported by grants from the National Institutes of Health. One author reported receiving stipend from the American Medical Association as Deputy Editor for JAMA Network Open.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.