Analysis of 22,655 presentations with back pain to Perth emergency departments over five years

To examine the characteristics of patients presenting with back pain to the ED, including final diagnosis, demographics of those attending and temporal distribution of presentations.Emergency presentations in the metropolitan area of Perth, Western Australia, for 2000-2004 were searched using a linked database covering all the major hospitals (Emergency Care Hospitalisation and Outcome Study database). All presentations with the triage code for back pain were extracted and analysed.A total of 22,655 presentations with back pain were identified, representing 1.9% of total presentations. Simple muscular or non-specific back pain accounted for only 43.8% of presentations, with other causes such as renal colic and pyelonephritis accounting for the majority. The young (<15 years old) and elderly (>75 years old) were more likely to have non-muscular causes for their back pain. Muscular back pain presentations occurred mostly between 0800 and 1600, with high proportions presenting on the weekends. Patients with simple muscular back pain spent a mean of 4.4 h in the ED, representing a significant outlay of resources.Back pain has a significant impact on EDs, and staff should be alert for another pathology presenting as back pain. There is a need for multidisciplinary back pain teams to be available 7 days a week, but only during the day.Back pain is a common problem and has a large effect on work productivity, mental health and physical activities. Approximately 80% of Australians suffer back pain at some time, and two thirds have some form of back pain in a 12-month period [1]. These findings are similar in other regions [2-5]. Back pain places strain on the health system with as many as 50% of sufferers still having problems at 5 years [6]. If initial treatment is effective, especially by a multidisciplinary team, then the recurrence rate and long-term disability can be reduced [2,7-9]. Determining when these teams, which usually consist of paramedical staff such as physi