When Should I Go to the Emergency Room for Back Pain?

Family Medicine, Primary Care Roots Community Health Center, Hippo Education, Kameda Medical Center

Supervised by Kenji Taylor, MD

Consider going to the emergency room (ER) for back pain if it is extremely intense, accompanied by difficultly walking or standing, or a loss of bowel or bladder control.

Explanation

Back pain can be caused by many things that span benign to life-threatening. Distinguishing between them can be challenging even for the seasoned clinician. Generally, extremely severe debilitating back pain, or pain accompanied by difficulty walking/standing, fevers/chills or loss of bowel/bladder control should prompt a visit to the emergency room. You may also consider if you have risk factors for more severe causes such as age (<18 or >50), immunocompromise, or underlying conditions such as cardiovascular, kidney, liver or bone disease.

(References)

Edwards J, Hayden J, Asbridge M, Gregoire B, Magee K. Prevalence of low back pain in emergency settings: a systematic review and meta-analysis. BMC Musculoskelet Disord. 2017 Apr 4;18(1):143. doi: 10.1186/s12891-017-1511-7. PMID: 28376873; PMCID: PMC5379602.
Knezevic NN, Candido KD, Vlaeyen JWS, Van Zundert J, Cohen SP. Low back pain. Lancet. 2021 Jul 3;398(10294):78-92. doi: 10.1016/S0140-6736(21)00733-9. Epub 2021 Jun 8. PMID: 34115979.
Urits I, Burshtein A, Sharma M, Testa L, Gold PA, Orhurhu V, Viswanath O, Jones MR, Sidransky MA, Spektor B, Kaye AD. Low Back Pain, a Comprehensive Review: Pathophysiology, Diagnosis, and Treatment. Curr Pain Headache Rep. 2019 Mar 11;23(3):23. doi: 10.1007/s11916-019-0757-1. PMID: 30854609.

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Family Medicine, Primary Care Roots Community Health Center, Hippo Education, Kameda Medical Center

Kenji Taylor, MD

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