Visiting the emergency room for back pain is usually one of the most frustrating experiences for any patient to endure. In fact, in the many years we have been helping to provide advocacy and education services for back and neck pain sufferers, the most common negative healthcare report that we receive from patients is their dissatisfaction with ER services.
The emergency room at your local hospital, medical center or clinic is designed to handle sudden scenarios of injury, disease or pain. We can think of no more severe expression than acute back pain. Patients are often taken to the emergency room via ambulance, unable to walk, stand or even speak, due to their unrelenting extreme symptoms. We have seen this occur countless times and have been victimized by the experience ourselves on several occasions.
Emergency services are typically overwhelmed in the volume of patients they must attend to, while simultaneously being notoriously short-staffed by qualified caregivers. This is one of the main reasons why treatment results in the ER are less than fulfilling. However, the most critical failure of the ER system is that it simply does nothing to diagnose the cause of pain and typically does not even provide any semblance of real relief for patients, despite hours spent waiting and hours more in various stages of evaluation.
Since ER dissatisfaction is a topic that we have commented on many times in the past, we have decided to address the subject in this dedicated essay. Herein, we will discuss why emergency room services often fail back pain sufferers and how patients might enjoy better diagnostic and treatment results from avoiding the practice of recurrently visiting the ER each and every time their back pain reaches critical mass.
Most people will visit the ER when they experience a severe attack of back pain the very first time. People are frightened to death by the severity of the symptoms and feel that something must be terribly wrong to elicit such agonizing expressions. ER visits may occur due to known back injury, perceived back injury or the simple commencement of misery from no known causation.
Getting to the ER can be a trial, since severe pain often prohibits normal postures. Patients might not be able to sit in a car and often report having to lie down across the back seat or even in the tailgate of a larger vehicle to receive transport to the hospital. Other patients simply call for an ambulance to transport them directly to the nearest hospital ER. However, there is no less misery in being strapped to a gurney for many people with acute dorsalgia. Regardless of the method used to reach the hospital physically, the journey is often a psychologically-scarring ordeal filled with truly horrific pain.
Once they arrive at the ER, patients who arrive by car or private transport will have to wait for an undisclosed length of time before being checked-in and will be kept in limbo for more time before being brought into an exam area. Luckily, patients who arrive by ambulance will typically be admitted directly into the exam area, without the long wait time for check-in.
Regardless, once inside the examination area, patients must typically wait for a very long time in order to see anyone who can help them. Nurses will come and go, taking basic vital signs, while doctors seem to be absent or inattentive. Eventually some doctor will show up and begin to evaluate the condition. They may or may not perform a physical exam or order basic diagnostic testing, such as x-ray or CT scan for suspected injuries.
Sometimes, immediate pharmaceutical interventions might be provided orally or via injection treatment. At least this might help to calm the patient and quiet their symptoms.
Patient citations place the average time to actually see a physician at just over 3 hours. Patients also cite that the entire evaluation process takes an average of 4 to 6 hours before any conclusion is reached regarding their case. Most of this time is spent waiting alone, in pain and without anyone to attend to their needs. Overall, the average time spent at a hospital emergency room for back pain is 6 to 9 hours.
All this invested time would be worthwhile if the results of admission to the local emergency room proved to be satisfying. However, the clearest statistic of all is that back pain sufferers are thoroughly appalled at the treatment they receive in ER settings.
Most patients spend hours in misery, undergo various tests and receive nothing more than a recommendation to follow-up with their family doctor or a particular type of specialist. Many are subjected to recurrent probing and constant movement for diagnostic evaluation, which often exacerbates symptoms to an intolerable degree. Few patients are even given a prescription to help them handle the acute pain, although this is certainly on a case-by-case basis.
We have heard from a few patients who actually did receive a diagnostic theory as to what might be causing their pain. These patients account for about 5% of all back pain-related ER visits.
The most satisfying results are certainly from patients who suffer a known injury that results in vertebral fracture or other diagnosable trauma. At least these patients made the right choice by seeking emergency care.
How about the remainder? Yes, the other 95%...
Most patients regret going to the ER, since they are still in pain, have no idea why they are suffering and now must still contact another doctor to begin the evaluation process all over again.
Of course, the fees for a visit to the emergency room for back pain can be very high, even for those who are lucky enough to enjoy major health insurance coverage. Co-pays alone usually amount to several hundred dollars, between the ER itself, the doctor consultations and the radiology fees. Many patients also become the victims of unethical balance billing practices that might cause them to be legally responsible for thousands of dollars in charges that should have been covered by their insurance. This is so common with specialists that request ER shifts in order to apply predatory tactics to ensure that patients will have no choice but to utilize their non-covered services.
As most of you know, I am not only the chief editor of this website, but I am also a fellow patient with a 30 year history of back and neck pain. I have been through the hospital ER gauntlet on several occasions and vowed a long time ago never to endure it again. None of my personal experiences were good, but one, in particular, has been detailed in several articles across The Cure Back Pain Network sites. This episode caused me to lose faith in emergency care for anything except highly specific circumstances, such as lacerations, heart attacks, strokes, births and other easily diagnosed and treated conditions. Seeking care at a local emergency room for back pain, or for anything else that needs diagnostic evaluation, is usually a fruitless process.
When it comes to back pain that is not linked to a definitive source process, the outpatient care provided will almost surely lack all efficacy and logic, but will not come without substantial monetary cost.
We would never suggest that patients should not seek care for their back pain. However, for those who have endured similarly disheartening experiences at your local ER, we just want you to know that you are not alone. You are among millions of people who seek emergency answers out of desperation and instead are simply provided more questions that require solutions, along with an exorbitant bill for “services” rendered.
At this stage, it does not surprise us one bit that many doctors routinely advise their chronic pain patients to stay clear of ER services, since they are unlikely to enjoy satisfying outcomes. Instead, it is probably best for these people to simply follow-up with a doctor who has intimate knowledge of their specific condition and actually cares about helping to provide relief.