Janie is a 50-year-old female who presents with a complaint of chronic low back pain. On examination, the patient reports that she spends most of her day sitting at a desk for work and has limited physical activity. Which of the following is the most appropriate INITIAL recommendation:  
A. Referral to a pain management specialist for further evaluation  
B. Prescription of a strengthening program for the low back and core   
C. Recommendation for the use of a lumbar support cushion while sitting  
D. Recommendation for a program focused on improving posture and ergonomics
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