Snapshot A 46-year-old man presents to his primary care physician with lower back pain. His symptoms began approximately 3 weeks ago and has not subsided. The pain does not radiate, and he cannot recall what caused this. He endorses having night sweats and unexpected weight loss. He denies illicit drugs use and does not smoke. On physical exam, no saddle anesthesia, muscle weakness, or sensory changes are noted. An erythrocye sedimentation rate and prostate-specific antigen is elevated. Radiography of the lumbar spine demonstrates a compression fracture of the lumbar spine. (Metastatic prostate cancer leading to lower back pain) Introduction Definition login to view 7 more bullets Epidemiology Incidence login to view 1 more bullet Risk factors login to view 4 more bullets Etiology Mechanical login to view 6 more bullets Nonmechanical login to view 15 more bullets Differential login to view 3 more bullets Presentation Symptoms/physical exam login to view 2 more bullets Red flag findings login to view 4 more bullets Imaging Radiographs login to view 3 more bullets MRI login to view 3 more bullets Studies Erythrocyte sedimentate rate login to view 1 more bullet Treatment In the absence of 'red-flag' symptoms, treat conservatively login to view 3 more bullets Otherwise, treatment is dictated by cause of pain