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Chronic low back pain — USMLE Step 3 MCQ

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ModerateAmbulatory Medicine / Primary CareChronic low back painUSMLE Step 3

A 42-year-old warehouse worker has 8 weeks of low back pain without fever, weight loss, trauma, neurologic deficit, or bowel symptoms. Straight-leg raise is negative. He wants imaging before returning to activity. Which of the following is the most appropriate next step in management?

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Correct answer: A — Recommend exercise-based physical therapy and avoid routine imaging

In nonspecific low back pain without red flags, active rehabilitation and avoiding early imaging are appropriate.

Reference: American College of Physicians low back pain guideline