Question

A 45-year-old office worker presents with acute low back pain radiating down the left leg after lifting a heavy box. He has no weakness, no sphincter disturbance and normal reflexes. He is otherwise well. What is the most appropriate initial management?

Accepted Answer

Advise staying active, simple analgesia and review if red-flag symptoms develop

Answer

Immediate MRI spine and urgent neurosurgical referral

Answer

Bed rest for 2 weeks and strong opioids

Answer

Refer urgently to physiotherapy-led spinal injection clinic

Answer

Start long-term benzodiazepines for muscle spasm

Practice question

A 45-year-old office worker presents with acute low back pain radiating down the left leg after lifting a heavy box. He has no weakness, no sphincter disturbance and normal reflexes. He is otherwise well. What is the most appropriate initial management?