A 60-year-old woman presents with chronic low back pain that began many years ago. Her back pain waxes and wanes, and she has taken acetaminophen and ibuprofen with some relief. About 3 months ago, she began to have daily pain. She recalls no trauma. Her examination is unremarkable other than some decreased flexion. Straight-leg raise test is negative. As the patient is older than 55 years of age, radiographs are ordered, and they demonstrate degenerative changes in her lumbar spine (Figure 101-1). She is started on an exercise program and yoga.