A 30-year-old man presents with acute onset of severe low back pain after lifting a heavy box. The pain does not radiate below the knee. He denies wea...

Question

A 30-year-old man presents with acute onset of severe low back pain after lifting a heavy box. The pain does not radiate below the knee. He denies weakness, saddle anesthesia, bowel or bladder dysfunction, weight loss, fever, or trauma. Neurologic exam is normal, and straight-leg raise test is negative. What is the most appropriate initial management?

Accepted Answer

Prescribe NSAIDs and encourage activity as tolerated

Answer

Order an urgent MRI of the lumbar spine

Answer

Refer for immediate neurosurgical consultation

Answer

Prescribe long-term opioids for pain control

Answer

Order lumbar spine radiographs

us-abfm MCQ (SBA): Acute Nonspecific Low Back Pain