The emergency department evaluation, management, and treatment of back pain

Back pain is one of the most common symptom-related complaints for visits to primary care physicians and is the most common musculoskeletal complaint that results in visits to the emergency department (ED). With recent national health care initiatives moving toward universal coverage, an increasing number of patients with common complaints such as back pain will visit the ED. The first goal of ED assessment of patients with back pain is to evaluate for potentially dangerous causes that, if not promptly recognized, could result in significant morbidity and mortality. This article focuses on the essential elements of an efficient and effective evaluation, management and treatment of patients with back pain in the ED, with special emphasis on epidural abscess, epidural compression syndrome, malignancy, spinal stenosis, and back pain in children.