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Acute low back pain — USMLE Step 3 MCQ

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EasyAmbulatory Medicine / Primary CareAcute low back painUSMLE Step 3

A 39-year-old man has low back pain after lifting a sofa 5 days ago. Pain radiates to the buttock but not below the knee. He has no fever, weight loss, trauma, cancer history, urinary retention, saddle anesthesia, or weakness. Examination shows paraspinal tenderness and normal reflexes. Which of the following is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Recommend activity as tolerated and NSAID therapy

Acute nonspecific low back pain without red flags is managed with activity and analgesia; early imaging is not indicated.

Reference: ACP low back pain guideline; USMLE Step 3 Content Outline