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Mechanical low back pain — USMLE Step 3 MCQ

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EasyAmbulatory Medicine / Primary CareMechanical low back painUSMLE Step 3

A 39-year-old warehouse worker has acute low back pain after lifting boxes 5 days ago. Pain radiates to the buttock but not below the knee. He has no fever, cancer history, neurologic deficit, trauma, or bowel or bladder symptoms. Straight-leg raise is negative. Which of the following is the most appropriate next step in management?

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Correct answer: C — Reassure, encourage activity, and use NSAIDs as needed

Acute low back pain without red flags is treated conservatively with reassurance, activity, and nonopioid analgesia; early imaging is not indicated.

Reference: ACP Low Back Pain Guideline