ArticlePrehospital and disaster medicine2025
Paramedic Management of Non-Traumatic Back Pain in a Large Australian Ambulance Service: A Retrospective Study.
Article in Prehospital and disaster medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors.
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Abstract
introductionNon-traumatic back pain commonly leads people to seek health care from paramedics via triple-zero (emergency phone number in Australia), yet the management approaches by providers of ambulance services remain unclear. STUDY
objectivesThis study aims to investigate paramedic management of non-traumatic back pain in New South Wales (NSW), Australia, including the call characteristics, provisional diagnoses, and the clinical care being delivered by paramedics.
methodsThis study is a retrospective analysis of NSW Ambulance computer-aided dispatch and electronic medical records from January 1, 2017 through December 31, 2022. Adults who sought ambulance service with a chief complaint of back pain, were triaged as non-traumatic back pain, and subsequently received treatment by paramedics were included. Multivariable logistic regression models were used to explore factors associated with primary outcomes; ambulance transport, opioid use, and use of medication combinations were reported as odds ratios (ORs).
resultsThere were 73,128 calls to NSW Ambulance with a chief complaint of back pain that were triaged as non-traumatic back pain. Of these, 54,444 (74.4%) were diagnosed with spinal pain, of which 52,825 (97.1%) were categorized by the paramedic as back or neck pain, 1,573 (2.9%) as lumbar radicular pain, and 46 (0.1%) as serious spinal pathology. Eight out of ten patients with spinal pain were transported to emergency departments. The medicine most administered by a paramedic was an opioid (37.4% of patients with spinal pain). Older patients (OR = 1.36; 95% CI, 1.30 to 1.44) were more likely to be transported to an emergency department. Patients with moderate (OR = 4.39; 95% CI, 4.00 to 4.84) and severe pain (OR = 18.90; 95% CI, 17.18 to 20.79) were more likely to be administered an opioid.
conclusionsParamedic management of non-traumatic back pain in NSW typically results in the administration of an opioid and transport to an emergency department.
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