Conditions
Low back pain
Assess for red flags, limit imaging, and focus on active recovery.
Last reviewed 2026-01-05|msk | pain | spine
Diagnosis
- Classify as non-specific, radicular, or specific cause based on history and exam.
- Perform neurologic exam when radicular symptoms are present.
Initial workup
- Imaging is not needed without red flags; focus on functional assessment.
- Screen for occupational, psychosocial, or mental health contributors.
First-line management
- Encourage staying active, gentle mobility, and return to normal activities.
- Use NSAIDs or acetaminophen as needed; consider short-term physiotherapy.
- Provide reassurance and self-management education.
Red flags
- Progressive neurologic deficit, saddle anesthesia, or bowel/bladder changes.
- History of cancer, significant trauma, or systemic infection signs.
Referral triggers
- Persistent radiculopathy or functional impairment beyond 6 weeks.
- Suspected spinal stenosis, fracture, infection, or malignancy.