A patient with acute back pain following a twisting injury without neurologic changes is likely suffering from which condition?

In the context of acute back pain following a twisting injury, the most likely diagnosis is a lumbosacral sprain or strain. This condition typically occurs due to overstretching or tearing of the ligaments (sprain) or muscles/tendons (strain) in the lower back, especially during activities that involve twisting or sudden movements. The absence of neurologic changes, such as numbness, weakness, or bowel and bladder dysfunction, supports this diagnosis, as those symptoms would be more indicative of serious conditions affecting the spinal cord or nerves.

In cases of a lumbosacral sprain/strain, patients often experience localized pain, tenderness, and muscle spasm without any significant neurological findings. This aligns with the scenario described, where the twisting injury has resulted in acute back pain without neurological compromise. Therefore, lumbosacral sprain/strain is the most plausible explanation for the patient's symptoms following the described mechanism of injury.