Purpose of review: This article provides an overview of evaluating and treating low back pain in the outpatient setting.
Recent findings: As most cases of acute low back pain have a favorable prognosis, current guidelines on imaging studies recommend conservative treatment for 6 weeks prior to obtaining an MRI if no red flags are present. Of these red flags, a prior history of cancer is the strongest risk factor for a malignant etiology and requires urgent evaluation with MRI. Management of acute low back pain is mainly conservative with oral non-narcotic analgesics and mobilization as the initial recommendations. For patients with radiculopathy, epidural steroids may result in short-term pain relief, but long-term effects are still unclear.
Summary: A systematic, evidence-based approach to the patient with low back pain is key to providing safe and cost-efficient care.