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Chronic noncancer pain — USMLE Step 3 MCQ

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ModerateAmbulatory Medicine / Primary CareChronic noncancer painUSMLE Step 3

A 49-year-old man with chronic low back pain asks for opioid medication. He has no cancer, neurologic deficit, or prior structured nonpharmacologic treatment. He is working and wants to remain active. Examination shows paraspinal tenderness only. Which of the following is the most appropriate next step in management?

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

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Correct answer: B — Offer exercise-based therapy and nonopioid analgesic options

Chronic noncancer low back pain is initially managed with active rehabilitation and nonopioid strategies.

Reference: Current US clinical practice standards and USMLE Step 3 content outline, https://www.usmle.org/exam-resources/step-3-materials