The Impact of COVID-19 On Emergency Visits For Back And Neck Pain

Abstract Purpose: To assess the rate of visits to the emergency department of our medical center concerning low back or neck pain, as a factor of COVID-19 confinements.Methods: The study period was a 30-weeks interval during the COVID-19 pandemic contrasted by a similar stretch in the year preceding the epidemic. The visits to the Emergency Department, prompted by low back or neck pain, were recorded prior and during lockdowns of the pandemic. The significance of the confinements for the development of the pain syndromes was evaluated.Results: A total of 1530 patients with newly diagnosed back or neck pain were enrolled. Most patients visited our emergency department for low back pain, commonly those older than 60 years. No significant gender variance was disclosed, though most visits of females were for low back pain. Low back pain presentations were curbed following confinement, but the rate of stays for neck pain had swelled by more than 10%. Despite back pain predominance, visits for neck pain persisted. Before COVID-19, the average weekly number of Emergency Department visits was 38.5. This was followed by sharp drops during COVID-19 lockdown (mean different=-22.2, 95%CI=-28.7, -15.7, p<0.001) (not significant).Conclusions: COVID-19 lockdowns have a significant impact on the Emergency Department’s presentations due to back and neck pain. A higher rate of presentation for back pain compared to neck pain is probably related to COVID-19, without being affected directly by the SARS-CoV-2: confinement-induced immobility might instigate musculoskeletal sequels, which may be attributed to stress or other psycho-social afflictions.

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The emergency visits for back and neck pain during lockdowns

10.21203/rs.3.rs-1254980/v1 ◽

2022 ◽

Author(s):

Nissim Ohana ◽

Itzhak Engel ◽

Yuval Baruch ◽

Benharroch Daniel ◽

Sheinis Dimitri

Keyword(s):

Emergency Department ◽

Low Back Pain ◽

Back Pain ◽

Neck Pain ◽

Medical Center ◽

Emergency Department Visits ◽

Low Back ◽

Newly Diagnosed ◽

Gender Variance ◽

Pain Syndromes

Abstract Purpose To assess the rate of visits to the emergency department of our medical center concerning low back or neck pain as a factor of COVID-19 confinement. Methods The study period was a 30-week interval during the COVID-19 pandemic contrasted by a similar stretch in the year preceding the epidemic. Visits to the emergency department prompted by low back or neck pain were recorded prior to and during lockdowns of the pandemic. The significance of the confinements for the development of pain syndromes was evaluated. Results A total of 1530 patients with newly diagnosed back or neck pain were enrolled. Most patients visited our emergency department for low back pain, commonly those older than 60 years. No significant gender variance was disclosed, although most visits of females were for low back pain. Low back pain presentations were curbed following confinement, but the rate of stays for neck pain swelled by more than 10%. Despite back pain predominance, visits for neck pain persisted. Before COVID-19, the average weekly number of emergency department visits was 38.5. This was followed by sharp drops during the COVID-19 lockdown (mean difference=-22.2, 95% CI=-28.7, -15.7, p<0.001) (not significant). Conclusions COVID-19 lockdowns have a significant impact on emergency department presentations due to back and neck pain. A higher rate of presentation for back pain compared to neck pain is probably related to COVID-19, without being affected directly by SARS-CoV-2: confinement-induced immobility might instigate musculoskeletal sequelae, which may be attributed to stress or other psychosocial afflictions.

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LO001: The prevalence of low back pain in the emergency department: a systematic review and primary study in the Charles V. Keating Emergency and Trauma Centre, Halifax, Nova Scotia, Canada

CJEM ◽

10.1017/cem.2016.38 ◽

2016 ◽

Vol 18 (S1) ◽

pp. S30-S30 ◽

Cited By ~ 1

Author(s):

J. Edwards ◽

J. Hayden ◽

K. Magee ◽

M. Asbridge

Keyword(s):

Systematic Review ◽

Emergency Department ◽

Low Back Pain ◽

Back Pain ◽

Nova Scotia ◽

Trauma Centre ◽

Emergency Department Visits ◽

Primary Study ◽

Low Back ◽

Charles V

Introduction: Low back pain (LBP) may be having a significant impact on emergency departments (ED) around the world. Two analyses conducted in the USA and Australia suggest that LBP is one of the leading causes of emergency department visits. However, in the peer-reviewed literature, there has been limited focus on the prevalence and management of back pain in the ED setting. Furthermore, the applicability of the available research to our local ED setting is unclear. Methods: This project includes two studies to investigate the prevalence of LBP in the ED: 1. a comprehensive systematic review of the published literature to gather a comprehensive and global perspective about the prevalence of LBP in the ED setting, and 2. a retrospective cross sectional analysis using six years of data from our local ED, the Charles V. Keating Emergency and Trauma Centre, Halifax, Nova Scotia. Results: Searches from multiple databases including PubMed (392 citations), resulted in 3024 citations, of which 20 studies were found to have prevalence data for LBP. Studies were reported between 2001–2015 and used mixed methods of data collection, including electronic databases, surveys and patient charts. Ranges for prevalence estimates were 1.9% to 17% of patient visits. Results indicated there are many gaps in the literature, for example research in rural EDs and in Canada. In our primary study, we have identified a sample of 10 000 patients presenting with LBP to our local ED. Analysis of this data will be completed prior to the CAEP conference. Conclusion: This project is the first systematic review; comprehensive search strategy to examine the prevalence of LBP in the ED. It is also the first project to assess the prevalence of LBP in a Canadian ED. Results from this study will inform healthcare providers, as well as administrative and policy decision-makers, of the global and local impact of LBP in the ED, and will identify opportunities for further research to enhance care pathways of patients suffering from LBP.

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Use of Imaging During Emergency Department Visits for Low Back Pain

American Journal of Roentgenology ◽

10.2214/ajr.19.21674 ◽

2020 ◽

Vol 214 (2) ◽

pp. 395-399

Author(s):

Jina Pakpoor ◽

Micheal Raad ◽

Andrew Harris ◽

Varun Puvanesarajah ◽

Joseph K. Canner ◽

...

Keyword(s):

Emergency Department ◽

Low Back Pain ◽

Back Pain ◽

Emergency Department Visits ◽

Low Back

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Low Back Pain in a Nova Scotian Emergency Department: Prevalence and Patient Characteristics in the Older Adult Patient Population

Canadian Journal on Aging / La Revue canadienne du vieillissement ◽

10.1017/s0714980821000118 ◽

2021 ◽

pp. 1-9

Author(s):

Lucy Federico ◽

Melissa K Andrew ◽

Rachel Ogilvie ◽

Maria Wilson ◽

Kirk Magee ◽

...

Keyword(s):

Older Adults ◽

Emergency Department ◽

Low Back Pain ◽

Back Pain ◽

Resource Planning ◽

Patient Characteristics ◽

Emergency Department Visits ◽

Low Back ◽

Younger Adults ◽

Nova Scotian

Abstract Low back pain is a major cause of disability in older adults, and results in many emergency department visits each year. Characteristics of the older back pain population are largely unknown. We conducted a retrospective study to examine the prevalence and patient characteristics for older (≥ 65 years of age) and younger (16–64 years of age) adults presenting with back pain. Study objectives were to describe the characteristics of older adults with back pain presenting to an emergency department and to identify age-group based differences in management. Older adults were most commonly diagnosed with non-specific low back pain (49%). For older adults with this diagnosis, the length of stay was 2.1 times longer (p < 0.001), and odds of being admitted to the hospital were 5.1 times higher (p < 0.001) than for younger adults. Patterns of management are different for younger and older adults with low back pain; this information can be used to direct future resource planning.

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The impact of patient preferences and costs on the appropriateness of spinal manipulation and mobilization for chronic low back pain and chronic neck pain

BMC Musculoskeletal Disorders ◽

10.1186/s12891-019-2904-6 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Patricia M. Herman ◽

Margaret D. Whitley ◽

Gery W. Ryan ◽

Eric L. Hurwitz ◽

Ian D. Coulter

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Neck Pain ◽

Patient Preferences ◽

Chronic Low Back Pain ◽

Chronic Neck Pain ◽

Low Back ◽

System Perspective ◽

The Individual ◽

The Impact

Abstract Background Although the delivery of appropriate healthcare is an important goal, the definition of what constitutes appropriate care is not always agreed upon. The RAND/UCLA Appropriateness Method is one of the most well-known and used approaches to define care appropriateness from the clinical perspective—i.e., that the expected effectiveness of a treatment exceeds its expected risks. However, patient preferences (the patient perspective) and costs (the healthcare system perspective) are also important determinants of appropriateness and should be considered. Methods We examined the impact of including information on patient preferences and cost on expert panel ratings of clinical appropriateness for spinal mobilization and manipulation for chronic low back pain and chronic neck pain. Results The majority of panelists thought patient preferences were important to consider in determining appropriateness and that their inclusion could change ratings, and half thought the same about cost. However, few actually changed their appropriateness ratings based on the information presented on patient preferences regarding the use of these therapies and their costs. This could be because the panel received information on average patient preferences for spinal mobilization and manipulation whereas some panelists commented that appropriateness should be determined based on the preferences of individual patients. Also, because these therapies are not expensive, their ratings may not be cost sensitive. The panelists also generally agreed that preferences and costs would only impact their ratings if the therapies were considered clinically appropriate. Conclusions This study found that the information presented on patient preferences and costs for spinal mobilization and manipulation had little impact on the rated appropriateness of these therapies for chronic low back pain and chronic neck pain. Although it was generally agreed that patient preferences and costs were important to the appropriateness of M/M for CLBP and CNP, it seems that what would be most important were the preferences of the individual patient, not patients in general, and large cost differentials.

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One Year of COVID-19 Pandemic in Italy: Effect of Sedentary Behavior on Physical Activity Levels and Musculoskeletal Pain among University Students

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18168680 ◽

2021 ◽

Vol 18 (16) ◽

pp. 8680

Author(s):

Federico Roggio ◽

Bruno Trovato ◽

Silvia Ravalli ◽

Michelino Di Rosa ◽

Grazia Maugeri ◽

...

Keyword(s):

Physical Activity ◽

Low Back Pain ◽

Back Pain ◽

Neck Pain ◽

Musculoskeletal Pain ◽

Activity Levels ◽

Low Back ◽

Physical Activity Levels ◽

One Year ◽

The Impact

The COVID-19 outbreak forced Italian students to reduce their daily activities, inducing a seden-tary attitude that was worsened by distanced learning. This study aimed to survey the physical activity levels that were maintained before and during the social restrictions following the pan-demic, their correlation to musculoskeletal pain, as well as analyzing the impact of these COVID-19 restrictions on pain and fatigue that affects daily life activities. A total of 2044 students completed the online questionnaire, of which the results of 1654 participants were eligible. Before the pandemic, the levels of physical activity were distributed as: 19.9% no activity, 30.1% light ac-tivity, 21.5% moderate activity, and 28.5% high activity. After one year of the pandemic, 30.6% of the participants were inactive, 48.1%, 10.9%, and 10.5% stated as maintaining, respectively, light, moderate and high levels of physical activity. Furthermore, 43.5% reported neck pain and 33.5% stated to experience low back pain. Physical activity levels lower than 150 min/week may have predisposed students to suffer from neck pain (1.95 OR at 95% CI, 1.44–2.64) and low back pain (1.79 OR at 95% CI, 1.29–2.49). A positive correlation between physical activity levels, Verbal Descriptive Scale (VDS), and pain frequency have been observed for neck and low back pain (p-value < 0.05). Finally, low physical activity levels were associated with musculoskeletal pain onset and pain worsening.

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