Review Question - QID 4895

A 66-year-old Caucasian female presents to the ER with severe new low back pain after she slipped on the curb yesterday night. You see her 3 hours after admission, and two hours after she was given 5 mg of oxycodone. She states she had no back pain prior to the fall, and a CT scan of the abdomen obtained 2 months earlier for abdominal pain demonstrated no evidence of a fracture. Her past medical history is significant for hypertension and hyperlipidemia. On physical exam she has 5/5 strength in all major muscle groups, normal sensation, 1+ patellar and achilles reflexes, no clonus and a down-going Babinski sign. While it causes her significant pain, she is able to stand and walk to the exam room door and back. A lateral radiograph is seen in Figure A. What would be the most appropriate first line of treatment.