• Howard S Kim, Kyle J Strickland, Amee L Seitz, and Danielle M McCarthy.
• Department of Emergency Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Center for Health Services and Outcomes Research, Northwestern University Feinberg School of Medicine, Chicago, IL. Electronic address: howard.kim@northwestern.edu.
• Ann Emerg Med. 2023 Aug 1; 82 (2): 154163154-163.

Study ObjectiveLow back pain is a common reason for visiting the emergency department (ED), yet little is known about patient motivations for seeking emergency care. The purpose of this study was to explore patient perspectives on visiting the ED for low back pain to inform a more patient-centered approach to emergency care.MethodsWe conducted focus group discussions and individual interviews among patients visiting an urban academic ED for acute low back pain. We recruited participants from an ongoing prospective study of 101 patients receiving either ED-initiated physical therapy or usual care. We conducted discussions, and interviews using an a priori developed discussion guide. We audio recorded, transcribed, and iteratively content analyzed the data using a consensual qualitative approach until thematic saturation was reached.ResultsWe conducted 4 focus group discussions among 18 participants (median age 46.5 years, 66.7% women, 61.1% Black) and individual interviews with 27 participants (median age 45 years, 55.6% women, 44.4% White). No new themes emerged during the fourth and final focus group. We identified 5 summary themes: (1) the decision to seek emergency care for low back pain is motivated by severe pain, resulting disability, and fears about a catastrophic diagnosis, (2) participants sought various goals from their ED visit but emphasized the primacy of pain control, (3) participants were reluctant to use pain medications but also acknowledged their benefit, (4) participants perceived a number of benefits from direct access to an ED physical therapist in the ED, and (5) participation in physical therapy ultimately facilitated recovery, but the pain was a barrier to performing exercises.ConclusionsThese patient perspectives and resulting themes may be used to inform a more patient-centered emergency care experience and contextualize quantitative research findings on ED care for low back pain.Copyright © 2022 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

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