Low back pain is a frequent health problem and causes substantial costs. Between 2007 and 2010 a panel of interdisciplinary experts in Germany developed evidence-based national guidelines for the management of nonspecific low back pain. These guidelines cover diagnosis (red flags and yellow flags), treatment recommendations and health care algorithms. In acute nonspecific low back pain diagnostic imaging is not indicated and should be avoided. Education and patient information, maintenance of routine daily physical activities and pain therapy as needed are the cornerstones of acute nonspecific low back pain therapy. In order to prevent the development of chronic back pain in patients with acute nonspecific back pain, the early identification of parameters predictive of a high risk of chronicity (yellow flags) is of particular importance even in primary care.