Low back pain is one of the most common reasons for consultation encountered in the primary care setting. The majority of cases are due to mechanical low back pain; however, proper evaluation is needed to identify patients who have secondary causes. This can be done through a focused history and physical examination using the Look-Move-Feel Approach as a guide. Identification of red flags suggests underlying pathology. The mnemonic BACK PAINS (Bladder/bowel incontinence, Age extremes, Chronic infection, Known Malignancy, Pain worse at night, Acute trauma, IV drug/Immunosuppression, Neurologic findings, and Systemic symptoms) can be used to remember red flags of low back pain. In general, patients with non-specific low back pain often require no imaging or work-up, while those with red flags warrant diagnostic investigation and possible referral.