Between 50 and 80% of adults will experience lower back pain during their life(1). This condition is responsible for a significant portion of emergency room and primary care consultations and it creates a significant burden on the healthcare services and costs. Even if lower back pain causes a significant impact on the quality of life of the patients most causes are benign. This article presents a systematic approach to identifying the cause of lower back pain, summarizes the indications for further workup and presents current evidence for the management of this condition.