WASHINGTON, DC—New research examining emergency department visits for low back pain found a significant decline in the use of opioids for treatment, according to a study published in Annals of Emergency Medicine. This signals a shift in clinical practice due to heightened awareness of opioid overuse, the study authors said.

Low back pain was the primary reason for 1 in 20 emergency visits from 2016-2022, making it one of the most common reasons people seek emergency care.

Researchers analyzed National Hospital Ambulatory Medical Care (NHAMCS) data to capture trends in how emergency departments across the country diagnose and treat the common condition. They found that the rate of prescribing opioids to treat low back pain decreased considerably, from 32% in 2016 to 13% in 2022.

“The decline in opioid prescribing shows physicians are responding to evidence and changing their practice at a time of growing awareness of the opioid epidemic,” said Howard S. Kim, MD, MS, FACEP, lead study author and emergency physician at the Northwestern University Feinberg School of Medicine.

The study also identified stable X-ray use ranging from 36-43% of low back pain visits over time. This pattern suggests an opportunity to align practice with recent clinical guidelines advising selective use of imaging.

By highlighting trends in current care, the researchers hope their study will lead to continued efforts to improve the efficiency of low back pain care in emergency settings.

“We still have some progress to be made in finding ways to encourage appropriate use of X-rays for low back pain,” said Dr. Kim. “This is a hard problem to tackle, as the decision to order an X-ray is complex and driven by both clinician and patient factors.”