Low back pain is the major cause of disability. Many options are available for evaluation and management of low back pain. The purpose of this review is to present the available evidence for evaluation and management of low back pain. Clinicians should conduct a focused history and physical examination to help place patients with low back pain into 1 of 3 broad categories: mechanical, neuropathic or secondary low back pain. Clinicians should not routinely obtain imaging or other diagnostic tests in patients with nonspecific low back. For most patients, first-line medication options are acetaminophen or nonsteroidal anti-inflammatory drugs. Because the evidence for physical therapy, nerve blocks and surgery are conflicting, clinicians should choose familiar treatment based on evidence.