Back pain: medical evaluation and therapy

SUMMARY Most patients with acute low back pain or sciatica improve with appropriate conservative therapy, and most require no immediate diagnostic studies beyond a careful history and examination. □ In patients with "red flags" for visceral, malignant, or infectious causes or possible cauda equina syndrome, a more aggressive evaluation is mandatory. □ In patients whose pain does not respond to initial management or who have chronic symptoms, diagnostic reevaluation is appropriate.