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Atraumatic Back Pain.

Michael K Abraham1, Alison G Marshall2

  • 1Department of Emergency Medicine, University of Maryland School of Medicine, Mercy Medical Center, Baltimore, MD, USA.

Emergency Medicine Clinics of North America
|November 19, 2025
PubMed
Summary
This summary is machine-generated.

Atraumatic back pain affects most adults, leading to frequent emergency visits. This review categorizes causes, distinguishing emergent spinal pathologies from less urgent conditions for better diagnosis and management.

Keywords:
Back painMalignant epidural spinal cord compressionSpinal cord and cauda equina compressionSpinal epidural abscessSpontaneous epidural hematoma

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Area of Science:

  • Medical Science
  • Clinical Medicine
  • Emergency Medicine

Background:

  • Atraumatic back pain is highly prevalent, affecting up to 80% of adults.
  • It is a leading cause for primary care and emergency department (ED) visits.
  • In 2021, back pain accounted for 4.4 million ED visits in the US.

Purpose of the Study:

  • To review and categorize causes of atraumatic back pain.
  • To differentiate between emergent and less urgent spinal pathologies.
  • To aid in prompt diagnosis and management of back pain presentations.

Main Methods:

  • Literature review and synthesis of existing studies on atraumatic back pain.
  • Categorization of spinal pathologies based on urgency and severity.
  • Analysis of prevalence and ED visit data.

Main Results:

  • Serious spinal pathologies occur in 2.5% to 5.1% of ED back pain cases.
  • A clear distinction is made between emergent "worst first" conditions and other etiologies.
  • The review provides a framework for classifying back pain causes.

Conclusions:

  • Effective management of atraumatic back pain requires accurate categorization of underlying causes.
  • Distinguishing emergent conditions is crucial for timely intervention.
  • This classification aids clinicians in prioritizing patient care.