A Young Female Athlete With Acute Low Back Pain Caused by Stage IV Breast Cancer

Poor response to conservative treatment may indicate the working diagnosis is incorrect and that it must be reconsidered. In this case, a lack of response to care with persistent high severity of pain despite a multimodal approach justified further investigation with advanced imaging, which revealed spinal metastases secondary to breast cancer. Clinicians should be aware of history and physical exam indicators of red flag conditions that may present as low back pain.