A 55-year-old man presents with a history of dull low back pain that began approximately 10 days ago and is now worse in intensity and duration.

A 55-year-old man presents with a history of dull low back pain that began approximately 10 days ago and is now worse in intensity and duration. It is present constantly, is accompanied by some stiffness, but does not radiate to any other location. The pain is intensified with prolonged sitting and/or bending. Ibuprofen provides some pain relief and he is most comfortable lying down. He has experienced an episode of this type of pain in the past and it resolved spontaneously after 4-5 weeks. The pain was not associated with any specific precipitating event. He denies injury. He works as a driver and delivers packages for a postal company. He has been off work for 4 days and his employer requires he be evaluated before returning to work.