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Acute low back pain without red flags — USMLE Step 3 MCQ

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HardAmbulatory Medicine / Primary CareAcute low back pain without red flagsUSMLE Step 3

A 63-year-old man with chronic low back pain asks for imaging. Pain began 3 weeks ago after lifting furniture. He has no fever, weight loss, 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 — Conservative therapy without immediate imaging

Acute low back pain without red flags is managed conservatively without immediate imaging. Early imaging does not improve outcomes and can lead to unnecessary interventions.

Reference: American College of Physicians Low Back Pain Guideline