Back Pain Emergency - Emergency Room Visits

Approximately 98% of patients who experience back pan once, or on multiple occasions, are diagnosed with nonspecific acute back pain. This means that the onset of symptoms is rapid, that it will resolve on its own in days to a few weeks, and is not caused by a serious back injury or degenerative condition. That being said, many patients become very concerned when they do experience moderate to severe symptoms, and may schedule an emergency room visit to receive immediate care.

In the majority of cases, back pain is not a cause for concern and will usually get better on its own, once the pulled or strained muscles in the back have healed themselves to stop their muscle spasms. Back spasms are spasms of the back muscles, which are continuous contractions of the muscles that that become intensely tight in response to an injury to the spine or an injury to the muscle. These injuries may be severely painful, though they will usually improve in a matter of days regardless of treatment. Back pain related to muscle spasms are one of the most common causes of acute back pain and emergency room visits. These injuries aren't considered serious, and doctors will usually treat them conservatively, with the recommendation of bed rest, pain medications, and possibly muscle relaxants.

Emergency Room Visits: As mentioned above, 4 out of every people experience back pain at some time in their lives, and the majority of people develop temporary pain due to self-correcting conditions, such as muscle spasms and trained ligaments. Doctors take back pain seriously because it may it may be symptoms of compression of one or more spinal nerves, and because it may also be a symptom of a systemic disease. Patients take it seriously if they're in intense pain and incapacitated. Many patients may experience back pain symptoms that are significant enough that they seek medical attention immediately. When patients first present with back pain in the emergency room, doctors will first want to evaluate for a serious medical condition. Some red flags are:
  • Severe bone pain in the middle of the back
  • Unexplained weight loss or fever
  • Pain that increases when lying down or that becomes worse at night
  • Prolonged morning stiffness that lasts for hours
  • Pain that is associated with the menstrual cycle, urinating, or eating
  • The loss of bladder or bowel control
  • Lower back pain with associated muscle weakness in the leg or foot.
  • Severe back pain that presents itself immediately following a trauma, such as a car accident, sports collision, or fall. Back pain related to a trauma may indicate a bone fracture or other injury.
  • Patients who are vulnerable to fractures of the vertebral bones as the result of a pre-existing medical condition, such as multiple myeloma or osteoporosis.
  • Back pain in individuals with history of cancer will want to be evaluated for metastatic cancer that has spread to the spine. The most common cancers that may spread to the spine, in the event of it metastasizing, are prostate, lung, and breast cancer.

Back pain that involves neurologic deficits such as weakness in the foot/leg and those that are related to trauma are of the most concern to emergency room doctors. If the trauma is severe, emergency room surgery may be needed to stabilize the spine and remove pressure on the nerves. Decompression of the spinal nerves is important because the nerves may sustain permanent damage at some point. Fractures of vertebrae without nerve compression generally call for rest at home and bracing. Injuries that involve strains of the back muscles and strains of the ligaments, and not severe tears, are usually treated with medications and physical therapy.