A 58-year-old man with chronic low back pain for 10 months h…

A 58-year-old man with chronic low back pain for 10 months has tried exercise therapy and nonsteroidal anti-inflammatory medication with partial relief. He requests an opioid because “nothing else works.” He has no red flags, uses alcohol socially, and takes no sedatives. What is the most appropriate next step before considering any opioid trial?