A 24-year-old presents with low back pain of 2 days’ duration. The patient is a manual laborer and reports lifting a heavy box while at work the previous day. Initially, the patient had no complaints, but the following day, stiffness and pain began. The patient denies radiation of the pain, numbness, or difficulty with urination. They deny previous complaints of back pain or injury. On physical examination, there is paravertebral muscle spasm and a slight decrease in range of motion of the spine. Lower extremity deep tendon reflexes are equal bilaterally, and no sensory or motor deficits are noted. Which of the following is the most appropriate intervention at this time?

(A)          Initiate a short period of rest, analgesia, and progressive functional program

(B)          Magnetic resonance imaging (MRI) of the lumbar spine

(C)          Radiographs of the lumbar spine

(D)          Refer the patient for trigger point injections

(E)          Return the patient to work with no limitations


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