Did you go to the emergency room for lower back pain? Was your experience as frustrating as most? Based on our worldwide advocacy work, we can almost bet that it was… especially if you live in America, where ER visits for any type of back pain are usually fruitless, expensive, time-wasting ordeals in suffering.
Emergency rooms are set up to treat emergencies. This makes sense. While back pain might not threaten life itself, it creates complete functional disability and immense torment of body and mind. I would certainly classify the worst cases of lower back pain as emergency situations, since patients are often in a panic over the source of their discomfort, as well as being debilitated by the symptoms themselves. Why do ER visits provide such unsatisfying experiences? Why have most lower back pain patients decide to never again visit a hospital when their back flares-up? What can be done to make the future better for patients with acute attacks of lumbar dorsalgia?
This editorial essay provides a critical analysis of the failings of modern emergency care for back pain victims. We will also suggest some remedies that could fix much of the broken emergency care system to the benefit of hospital and patient alike.
Emergency Room for Lower Back Pain Experiences
I must say that I have a personal stake in this essay, having gone to the emergency room previously with acute lower back symptoms. I found the experience to be exactly as depicted in the remainder of this essay, which is how it is reported to us by literally tens of thousands of readers over more than 15 years of time.
Most patients only consider an ER visit when their symptoms are absolutely horrific. People report being deathly afraid of paralysis or even death when they have pain that is so severe that it brings tears to their eyes and immobilizes them. For the purposes of this article, we have discounted any reader experiences that do not fit this desperate state of truly being an emergency.
Arrival at the medical facility might occur via private care or ambulance. If brought in by ambulance, the patient will have the opportunity to wait inside a triage unit instead of having to negotiate the slow and painful process of checking-in (walking back and forth to various nurses’ stations and desks, then being offered a seat to fill out papers when you can’t even sit or move). Patients who arrive at the ER by themselves often wait for hours in the waiting room until they are finally brought in to a triage unit where they wait more. Ambulance-delivered patients simply wait in triage while people bring them forms and ask lots of questions, basically none that relate to the current pain, but instead, relate to the ability to pay for services yet to be rendered…
Eventually, a doctor or physician’s assistant will come in to examine the patient. This could be an hour later or several. In my own case, I believe I waited about 4 or 5 hours before seeing anyone. Once examined, the doctor will observe the patient’s pain level and often order some medication immediately. This therapy might range from as little as 2 acetaminophen to something as powerful as meperidine or morphine injections. Relief is usually minor, if any at all.
I was given 2 injections of Demerol back to back and felt myself sink into a big, black hole mentally. However, these shots did nothing at all to reduce my horrible pain. I could not be examined, since I could not move at this point. Not at all. We find this very common in patients in such acute states once they recline in a bed and are made to wait for hours.
At some point, maybe an hour or several hours later, a conclusion will be reached as far as how to proceed. During this time, patients will be observed, but basically ignored. Some patients will undergo emergency x-ray or CT scan imaging. If the latter is provided, the patient might gain some indication of cause or at least peace of mind. In my case, no imaging was offered and requests for such were denied. “Make an appointment”.
Patients will eventually be released, possibly with a small quantity of pain medication and told to follow-up with their normal doctor. Rarely will a physician be recommended, even if one is requested. For most patients, this process takes between 4 and 24 hours. For me, it was closer to 14. I left the hospital unable to walk and with no answers as to why my pain was so severe that the attending physician, a man of advanced years, called me “the most acute case of lumbar back pain he had ever seen in his life”.
ER for Lower Back Pain Problems
Since we now have a good image of what it is actually like to visit a hospital ER for acute lower back pain, we can objectively identify the main problems that exist for most patients and most facilities. In our advocacy efforts, we work closely with hospitals, so we will try to be fair and include their point of view, as well as in this section:
Patients who arrive in desperate pain should not be forced to move about from station to station during registration. This is idiotic and inhumane. Fortunately, if you arrive by ambulance, you can bypass this ordeal.
Patients must wait and wait and wait, for no reason other than the facility being short-staffed. We know that hospitals generally staff their ER with residents, who are “doctors in-training” or opportunistic caregivers who refuse to accept health insurance coverage and instead lie in predatory await to scam patients in need of care with balanced billing nightmares.
Patients are rarely offered any type of effective pain relief. If offered at all, relief MUST come in the form of drug therapies, which are to be arduously avoided due to their significant inherent dangers to health and life itself.
Medical imaging is rarely offered in emergency situations for back pain, and if it is, consists of x-rays or CT scan at best. We have only received a few reports of patients enjoying the benefit of MRI evaluation in a hospital emergency room setting. This is ridiculous.
Patients in ER do not have access to doctors who actually treat (or even seem to know anything about) back pain. Most are of unrelated specialization and seem clueless and helpless to deal with the consequences of acute presentations of lumbar dorsalgia.
When patients are finally released, 4 to 24 hours later, they regret going to the emergency room in over 98% of cases. These patients spent time and lots of money to learn nothing about the nature of their pain, nor receive any adequate treatment. What is the point of a hospital if it does not help people who need it? This is unacceptable.
Emergency Room for Lumbar Back Pain Solutions
Below, we provide some guidance of both patients, as well as hospitals that actually want to serve their patients better:
Regardless of how bad your pain is, you might not want to go to the emergency room. We know how frightening this type of pain can be, but the overwhelming base of statistics ranks ER visits for back pain as “the most disappointing of all heath issues”. This does not apply if you were hurt in a traumatic accident, such as an MVA or significant fall, since these case profiles should always be evaluated by an emergency medical team.
Instead, you might consider contacting your own physician or a specialist in orthopedics or neurology, to request an emergency appointment. Your time and money will be better spent on this path and you will likely move along much quicker in the diagnostic process.
You might consider seeing a complementary caregiver, such as a chiropractor or massage therapist, particularly if acute flare-ups are a recurrent problem for you and you already know your diagnosis.
Alternatively, you might simply decide to wait out the worst of the pain in the comfort of your own home. You may not expect it, but this path is rated highest in terms of patient satisfaction reports by a huge margin.
For care institutions that want to do a better job, let us make the following suggestions. Some may seem impossible to you, but that is simply because of the huge overall problems with the westernized medical system, its out-of-control costs and the way physicians are currently paid and treatments marketed:
Provide care for back pain patients who arrive with special needs. Lower back pain is one of the most common of all cited reasons for visiting a hospital ER, yet the facilities still do nothing to accommodate patients’ needs. Address this problem, please!
Provide doctor services from physicians who actually treat back pain. Consider paying a doctor to be on call 24/7 to attend to dorsalgia sufferers. For the ridiculous fees paid to hospitals, this is the very least they can do.
Provide alternative methods of pain relief, such as massage, chiropractic, TENS, acupuncture, or at least topical pain relief products that do not poison us. Are you trying to help patients or kill them?
Make imaging service available to ER patients. Get more machines. Do not ask pained people to wait weeks for an appointment. This is callous and soulless. You can’t possibly tell us that the great demand will not pay for the expense many, many times over.
Stop saying that you are doing the best that you can with the budget you have. Medicine is the highest earning of all industries. We pay you ludicrous sums of money for basically nothing on a regular basis throughout our lives. It is your fault that your costs are out of control. Learn to manage your finances, reduce your operating costs and prioritize patient services, since this is your mission. Stop wasting resources and overpaying for basically everything!
Improve the bedside manner of caregivers. Teaching staff to keep a patient calm with a script of reassurance should be a priority, when in reality most hospital workers seem uncaring, unaffected or negative and nocebo-imparting.
We want things to get better. Do you? Then work for change, regardless of whether you are a patient, a care provider or an institution administrator.