07 April 2025
7 April 2025
Low back pain (LBP) is the leading cause of disability worldwide, with 80% of people experiencing LBP in their lifetime.
Guidelines recommend managing LBP in the community by staying active, limiting rest, and using self-management strategies, physical and psychological therapies, and simple pain-relieving medications. Despite these recommendations, many people present to Emergency Departments (EDs) for LBP management, with only a small number of these patients requiring emergency care. This places additional pressure on hospitals already burdened by overcapacity, ambulance ramping, and long outpatient wait lists.
Funding from the Allied and Scientific Health Office (ASHO) has enabled researchers from Central Adelaide Local Health Network (CALHN), the University of South Australia, and the Commission on Excellence and Innovation in Health (CEIH) to study LBP presentations in South Australian public hospital EDs. This research was lead by CALHN Senior Physiotherapist, Joseph Orlando.
- Data was gathered from six SA Health public hospital EDs over a five-year period.
- 11,709 cases of non-specific LBP or sciatica were identified.
- 1 in 3 patients with LBP arriving at EDs came via ambulance.
- 73% of patients were discharged from the ED.
- Patients admitted to hospital were typically older, unable to function safely at home, or had a suspected serious injury requiring further care.
- Many patients reported difficulties accessing or affording community healthcare, contributing to high hospital demand.
- Access to community healthcare is even more challenging for people in lower socioeconomic and regional areas, as well as Indigenous Australians.
These findings demonstrate the importance of investing in community healthcare to ensure people can manage LBP in the community, reserving hospital resources for people requiring emergency care. Hospital avoidance services, for example, provide rapid, comprehensive assessment and management by a team of physiotherapists, nurses, doctors, pharmacists, and other allied health staff outside of the ED. SA Health Urgent Care Hub is one such hospital avoidance service, accessible via referral from General Practitioners, SA Ambulance and EDs, operating 365 days a year at Sefton Park and Woodville. A new physiotherapist-led digital follow up pathway is being trialled at SA Health Urgent Care Hub, an innovative approach to providing support, reassurance, and ongoing care options for people recovering from an episode of LBP. For more information about SA Health Urgent Care Hub, visit SA Health - CALHN Integrated Care.
This research has been published in the Journal of Emergency Medicine Australasia (Orlando JF, Burke AJL, Beard M, Guerin G, Kumar S 2024, ‘Hospitalisations for non-specific low back pain in people presenting to South Australian public hospital emergency departments.’ Emergency Medicine Australia). For more information about this research, please contact Joseph Orlando, Senior Physiotherapist, Central Adelaide Local Health Network.