Treatment approach of low back Pain Rule out Cauda Equina syndrome by CT scan, MRI, Myelogram if positive go for Surgical decompression and evaluate for acute, severe symptoms suggestive of underlying medical illness individuals with constitutional symptoms of fever or wt. loss suggestive of a tumor or infection. Conservative therapy for patients not falling in above two groups regardless of the diagnosis at this stage as entire patients with low back pain are treated the same way at this stage. Early treatment is a waiting game. Bed rest, anti-inflammatory and muscle relaxant are the safest and most effective modalities. Treat conservatively and wait for 6 weeks for a response. Eighty percent relief then mobilise the patient. Combination of controlled physical activity, medications, back school, exercises and work evaluation should be considered a part of conservative therapy protocol.