However, if there are certain "red flag" symptoms present, plain radiographs (X-ray), CT scan or magnetic resonance imaging may be recommended. These red flags include:
History of cancer
Unexplained weight loss
Immunosuppression
Urinary infection
Intravenous drug use
Prolonged use of corticosteroids
Back pain not improved with conservative management
History of significant trauma
Minor fall or heavy lift in a potentially osteoporotic or elderly individual
Acute onset of urinary retention, overflow incontinence, loss of anal sphincter tone, or fecal incontinence
Saddle anesthesia
Global or progressive motor weakness in the lower limbs

Prevention
Moderate-quality evidence exists that suggests that the combination of education and exercise may reduce an individuals risk of developing an episode of low back pain. Lesser-quality evidence points to exercise alone as a possible deterrent to the risk of the condition. Management
Nonspecific pain
Patients with uncomplicated back pain should be encouraged to remain active and to return to normal activities. The management goals when treating back pain are to achieve maximal reduction in pain intensity as rapidly as possible, to restore the individuals ability to function in everyday activities, to help the patient cope with residual pain, to assess for side effects of therapy and to facilitate the patients passage through the legal and socioeconomic impediments to recovery. For many, the goal is to keep the pain at a manageable level to progress with rehabilitation, which then can lead to long-term pain relief.
A foraminotomy or foraminectomy may also be necessary, if the vertebrae are causing significant nerve root compression. A discectomy is performed when the intervertebral disc has herniated or torn. It involves removing the protruding disc, either a portion of it or all of it, that is placing pressure on the nerve root. Total disc replacement can also be performed, in which the source of the pain (the damaged disc) is removed and replaced, while maintaining spinal mobility. When an entire disc is removed (as in discectomy), or when the vertebrae are unstable, spinal fusion surgery may be performed. Spinal fusion is a procedure in which bone grafts and metal hardware is used to fix together two or more vertebrae, thus preventing the bones of the spinal column from compressing on the spinal cord or nerve roots.If infection, such as a spinal epidural abscess, is the source of the back pain, surgery may be indicated when a trial of antibiotics is ineffective. Surgical evacuation of spinal hematoma can also be attempted, if the blood products fail to break down on their own. Pregnancy
About 50% of women experience low back pain during pregnancy. Some studies have suggested that women who have experienced back pain before pregnancy are at a higher risk of experiencing back pain during pregnancy. It may be severe enough to cause significant pain and disability in as many as one third of pregnant women. Back pain typically begins at approximately 18 weeks of gestation and peaks between 24 and 36 weeks.