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Chronic low back pain — USMLE Step 3 MCQ

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EasyAmbulatory Medicine / Primary CareChronic low back painUSMLE Step 3

A 46-year-old warehouse worker has 6 weeks of low back pain after lifting boxes. Pain does not radiate below the knee. Neurologic examination is normal and he has no fever, weight loss, cancer history, trauma, or bowel symptoms. 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 — Physical therapy, activity as tolerated, and nonopioid analgesia

Subacute low back pain without red flags is managed conservatively with activity, physical therapy, and nonopioid pain control.

Reference: ACP Low Back Pain Guideline