The typical course of benign back pain should not persist for 9 months and should be relieved with rest. This patientıs history is worrisome for either a spinal tumor or infection. With a past medical history significant for breast cancer and a few positive red flag signs (eg, fever, chills, night sweats, unintentional weight loss, anorexia, fatigue, rest or night pain), further evaluation is indicated. While advanced imaging will almost certainly be required, initial management should still begin with plain radiographs. Treatment with anti-inflammatory medications, physical therapy, and epidural steroid injections should be considered only when a thorough work-up is completed and a pathologic etiology has been ruled out.
- Plain radiographs of the lumbar spine.
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Seminars in Medical Practice
Hospital Physician Board Review Manuals
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