Management of acute low back pain in emergency departments in São Paulo, Brazil: a descriptive, cross-sectional analysis of baseline data from a prospective cohort study

Abstract

ObjectiveTo describe management strategies used in public emergency departments in a middle-income country for patients with acute non-specific low back pain.DesignA descriptive, cross-sectional analysis of baseline data from a prospective cohort study.Setting and participantsA study with 600 patients with low back pain presenting in four public emergency departments from São Paulo, Brazil was conducted.Outcome measuresDiagnostic tests, pharmacological interventions, and/or referral to other healthcare professionals were collected. Descriptive analyses were used to report all outcomes.ResultsOf all patients, 12.5% (n=75) underwent some diagnostic imaging tests. Medication was administered to 94.7% (n=568) of patients. The most common medications were non-steroidal anti-inflammatory drugs (71.3%; n=428), opioids (29%; n=174) and corticosteroids (22.5%; n=135). Only 7.5% (n=45) of patients were referred to another type of care.ConclusionThere is a need for research data on low back pain from middle-income countries. There was an acceptable rate of prescription for diagnostic imaging tests. However, there were high medication prescriptions and small rates of referrals to other healthcare services. Our findings indicate that there is still a need to implement best practices in the management of acute low back pain at public emergency departments in Brazil.

Efficacy of Photobiomodulation Therapy in the Treatment of Pain and Inflammation: A Literature Review

“…Of the selected trials, seven dealt with how chronic pain is or is not modified after the application of PBM [ 16 , 18 , 19 , 20 , 21 , 23 , 33 , 34 ], with the VAS being used as the main element for measuring pain.…”

“…Chronic nonspecific low back pain is the most prevalent painful musculoskeletal condition. It is heterogeneous since it can have many causes and diagnoses, but there are very few therapies with solid evidence of efficacy [ 33 ].…”

“…Low-level light therapy has played a different role in each study. In one study [ 33 ] the EG consisted of seven men and thirteen women with an average age of 47 years. After the interventions were carried out and the results evaluated, the subjects were found to have experienced significant improvements in pain and functional state with the improvements lasting for the 3-month treatment period.…”

Applying a knowledge translation framework for triaging low back pain and radicular pain at an emergency department: an iterative process within an uncontrolled before-and-after design

“…Yet, this was after exclusion of red flag patients. 51 Future research could explore the use of an appropriateness score when ordering imaging for LBP in EDs 52 and explore how general practice 53 and ED can work together in their struggle to reduce imaging. This is a description of a process that spanned almost ten years.…”

“…However, in April 2022 a study got published and the authors found a rate of 11% X-ray use and 0.5% CT scan use. Yet, this was after exclusion of red flag patients 51. Future research could explore the use of an appropriateness score when ordering imaging for LBP in EDs52 and explore how general practice53 and ED can work together in their struggle to reduce imaging.…”