"Go and get it checked": Exploring the decision to attend the emergency department for low back pain

Low back pain affects individuals and society, straining Emergency Departments (EDs) and prolonging wait times. While personal factors influence ED visits, third-party advice's role is underexplored. Limited guidance for healthcare professionals emphasises the need for effective back pain management to ease system strain and improve patient outcomes. This study examines motivations for ED visits due to low back pain.

This research utilised secondary analysis of qualitative data from a previous multisite study, adopting a subtle realist approach. From August to December 2021, 47 patients (26 M:21 F, aged 23-79) with back pain were sampled from four English EDs (2 Northern, 2 Southern) to capture diversity in sociodemographic and LBP characteristics. Eight patients had previously visited the ED for this back pain episode. During the pandemic, semi-structured interviews were conducted online, audio-recorded, transcribed, and analysed thematically. Three key themes influenced decisions to attend ED: Healthcare professionals, trusted others, and individuals. Healthcare professionals often dictated choices, making participants feel powerless. Trusted others offered varying support, acting as allies. Individuals wrestled with anxiety about pain severity and uncertainty regarding LBP.

This study emphasises the need for healthcare professionals to offer clear guidance on when individuals and their caregivers should visit the ED for back pain. Findings show that pain-related worries significantly drive ED visits, misaligning with practice guidelines. Healthcare providers must consider these issues when creating strategies to manage low back pain patients and optimise ED resources.