For a 54-year-old man with low back pain and no neurologic deficits, initial treatment recommendations would typically include physical therapy, medication, and massage therapy but would exclude surgery unless other conservative treatments fail.
Based on the scenario presented, where Greg, a 54-year-old man, is experiencing low back pain with a negative neurologic involvement in his physical exam, the recommendation would not include surgery as an immediate intervention. Chiropractors often use a drug-free, hands-on approach to treating such conditions involving the musculoskeletal system without resorting to invasive procedures.
The appropriate interventions would start with physical therapy, possibly incorporate medication for pain management, and could include massage therapy as part of a comprehensive treatment plan aimed at relieving symptoms and improving function without rapid progression to surgical options.