Systemic corticosteroids for acute low back pain: Do we treat because we are expected to?

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Trigger CaseAn elderly patient came to see me because her “regular doctor” was away on vacation. Two days earlier she had developed severe 10/10 low back pain. “Dr. Regular gives me steroid pills for back pain,” she explained. As we proceeded through a medical history, physical examination, and a review of her x-rays, there was nothing to suggest she had cord impingement, cauda equina syndrome, infection, neoplasm, or fracture.

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