{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:49:06Z","timestamp":1787770146131,"version":"build-2784847793"},"reference-count":98,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T00:00:00Z","timestamp":1757980800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pain Res."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Low back pain (LBP) uses a large proportion of health care resources. Data are needed for health care planning, measuring adherence to guidelines for quality assurance, and assessing overuse and underuse of health care services. The aim of this review is to summarize claims data and describe trends in health care utilization for LBP for the years 2000 to 2020.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This scoping review summarizes studies and health reports using claims data of people aged \u226515 years covered by a statutory health insurance in Germany for the period 2000 to 2020. We searched publications in PubMed, EMBASE and Google. Data on health care services were extracted and trends over the years were summarized.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included data from 76 publications, health reports and online databases. Every year, 25 to 32% of adults in Germany seek care for LBP. Most of the claims data cannot be pooled because of differences in standardization and reporting. However, trends are observable. Magnetic resonance imaging increased to 7.5%, plain radiography decreased to 15%. The number of sick leave days decreased slightly over time. Hospital admissions for LBP, spinal surgery, and opioid use increased. Outpatient rehabilitation increased, but the overall use of rehabilitation services remained relatively stable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Inconsistent reporting standards and fragmentation of German claims data reporting, hinders a comprehensive understanding of health service utilization for low back pain. Despite limitations, current data suggest potential overuse of resources for LBP in Germany, consistently with international data. Given the high proportion of patients consulting for LBP better monitoring of health service utilization is needed to improve quality of care and resource allocation.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpain.2025.1661722","type":"journal-article","created":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T05:36:18Z","timestamp":1758000978000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Health service utilization for low back pain in Germany between 2000 and 2020\u2014a scoping review of claims data"],"prefix":"10.3389","volume":"6","author":[{"given":"Julia","family":"Truthmann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Kiel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Vrana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Fran\u00e7ois","family":"Chenot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1211","DOI":"10.1016\/S0140-6736(17)32154-2","article-title":"Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990\u20132016: a systematic analysis for the global burden of disease study 2016","volume":"390","author":"Vos","year":"2017","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e316","DOI":"10.1016\/S2665-9913(23)00098-X","article-title":"Global, regional, and national burden of low back pain, 1990\u20132020, its attributable risk factors, and projections to 2050: a systematic analysis of the global burden of disease study 2021","volume":"5","year":"2023","journal-title":"Lancet Rheumatol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1663","DOI":"10.1007\/s00296-019-04430-5","article-title":"Health-care utilisation for low back pain: a systematic review and meta-analysis of population-based observational studies","volume":"39","author":"Beyera","year":"2019","journal-title":"Rheumatol Int"},{"key":"B4","doi-asserted-by":"publisher","first-page":"62","DOI":"10.3122\/jabfm.2009.01.080102","article-title":"Overtreating chronic back pain: time to back off?","volume":"22","author":"Deyo","year":"2009","journal-title":"J Am Board Fam Med JABFM"},{"key":"B5","doi-asserted-by":"publisher","first-page":"100565","DOI":"10.1016\/j.xnsj.2024.100565","article-title":"Health care utilization among medicare beneficiaries with newly diagnosed back pain","volume":"20","author":"Barros Guinle","year":"2024","journal-title":"North Am Spine Soc J"},{"key":"B6","doi-asserted-by":"publisher","first-page":"e193676","DOI":"10.1001\/jamanetworkopen.2019.3676","article-title":"Expenditures and health care utilization among adults with newly diagnosed low back and lower extremity pain","volume":"2","author":"Kim","year":"2019","journal-title":"JAMA Netw Open"},{"key":"B7","doi-asserted-by":"publisher","first-page":"622","DOI":"10.1016\/j.spinee.2011.03.017","article-title":"Real-world practice patterns, health-care utilization, and costs in patients with low back pain: the long road to guideline-concordant care","volume":"11","author":"Ivanova","year":"2011","journal-title":"Spine J"},{"key":"B8","article-title":"European Observatory on Health Systems and Policies","author":"Bl\u00fcmel","year":"2020"},{"key":"B9","first-page":"37","volume-title":"R\u00fcckenschmerzen","author":"Raspe","year":"2012"},{"key":"B10","article-title":"GEK-Heil- und Hilfsmittel-Report 2006: Auswertungsergebnisse der GEK-Heil- und Hilfmitteldaten aus den Jahren 2004 und 2005. 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