• Posted July 16, 2025

ER Opioid Prescriptions For Low Back Pain Cut In Half

Folks seeking relief from low back pain in an ER aren’t likely to leave with a prescription for opioids.

The rate of ER opioid prescriptions for back pain fell by more than half between 2016 and 2022, researchers reported July 12 in the Annals of Emergency Medicine.

Back in 2016, nearly a third of these visits (32%) resulted in a prescription for opioid painkillers, researchers found.

That had decreased to more than 13% of visits by 2022, researchers said.

“The decline in opioid prescribing shows physicians are responding to evidence and changing their practice at a time of growing awareness of the opioid epidemic,” lead researcher Dr. Howard Kim, an emergency physician at Northwestern University Feinberg School of Medicine in Chicago, said in a news release.

For the study, researchers analyzed records collected by the National Center for Health Statistics for nearly 53 million ER visits for low back pain that occurred between 2016 and 2022.

Patients were in considerable pain when they sought help, with an average pain score of more than 7 out of 10, researchers found. On average, they waited about 37 minutes before a doctor saw them, and spent about four hours in the ER.

Results show that NSAIDs like ibuprofen are now the prescription painkiller of choice, provided to nearly 29% of low back pain patients in the ER.

Patients also are less likely to have opioids administered during ER treatment, falling from 35% of cases in 2016 to less than 25% in 2020.

However, ER doctors haven’t embraced all recommended changes in back pain treatment, researchers said.

Many back pain patients who go to the ER are still getting unnecessary X-rays, results show.

About 37% of patients got an X-ray in 2022, about the same proportion as in 2015. The highest rate of X-rays, nearly 44% of cases, occurred in 2021.

“We still have some progress to be made in finding ways to encourage appropriate use of X-rays for low back pain,” Kim said. “This is a hard problem to tackle, as the decision to order an X-ray is complex and driven by both clinician and patient factors.”

More information

The Cleveland Clinic has more about low back pain.

SOURCES: Annals of Emergency Medicine, July 12, 2025; Northwestern University, news release, July 14, 2025