Decreasing Rates of Patients With Low Back Pain Presenting to Emergency Departments: An Age and Sex-Specific Review of National Injury Data From 2014 to 2023.

Abstract

To analyze trends in low back pain presentations to US emergency departments (EDs) and identify associated risk factors and barriers to care. Retrospective analysis using data from the National Electronic Injury Surveillance System (NEISS) from 2014 to 2023. Low back pain is one of the most common reasons for seeking medical care in the United States. Post-COVID-19, many older adults seem to defer care. Understanding trends in low back pain incidence can highlight potential improvements in prevention and gaps in health care access. NEISS data from January 1, 2014, to December 31, 2023, were queried for lower trunk injuries coded as strain/sprain. Narratives consistent with low back pain were included. Demographic and injury-related data were analyzed to estimate trends and outcomes. The query identified 48,829 cases of low back pain, corresponding to a national estimate (NE) of 2,001,384 cases. Low back pain incidence decreased significantly over the study period [P<0.001, β=-0.967, 95% CI: (-25216.56, -16296.58)]. Most cases involved patients aged 46-65 (29.8%) and 31-45 (28.8%). Common causes of injury included stairs (8.8%) and flooring (7%), with 51.3% occurring at home. Males and females accounted for 50.8% and 49.2% of cases, respectively. Hospitalization rates averaged 1.2%, peaking at 2.4% in 2022. Low back pain incidence in US EDs has declined over the past decade, possibly reflecting better prevention or alternative care pathways. However, steady hospitalization rates suggest injury severity remains unchanged. Further research is needed to assess care-seeking patterns, risk factors, and prevention strategies to address the burden of low back pain. Level III.