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For adults with limited baseline walking/exercise who present with an episode of low back pain, introducing a walking program with education about back pain increases the time between back pain episodes and decreases how often they present to a healthcare provider.

Source
Effectiveness and cost-effectiveness of an individualized, progressive walking and education intervention for the prevention of low back pain recurrence in Australia (WalkBack): a randomized controlled trial. Lancet. 2024 Jul 13;404(10448):134-144. doi: 10.1016/S0140-6736(24)00755-4. Epub 2024 Jun 19. PMID: 38908392

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Unfortunately, topical diclofenac did not demonstrate substantial pain control and provided no added benefit, even when co-administered with oral ibuprofen for specific patients with acute low back pain.

Source
Topical Diclofenac Versus Oral Ibuprofen Versus Diclofenac + Ibuprofen for Emergency Department Patients With Acute Low Back Pain: A Randomized Study. Ann Emerg Med. 2024 Jun;83(6):542-551. doi: 10.1016/j.annemergmed.2024.01.037. Epub 2024 Mar 2. PMID: 38441515

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While the majority of neck-related health care visits are self-limiting, in the correct context, a focused history and physical exam could unearth an undiagnosed cervical spinal cord compression potentially circumventing permanent disability.

Source
Clinical Examination of the Cervical Spine. N Engl J Med. 2023 Oct 26;389(17):e34. doi: 10.1056/NEJMvcm2204780.

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In this multicenter, randomized controlled trial comparing suturing the fingernail back onto the nail bed versus simply covering the nail bed with a non-adherent dressing after repair of a nail bed injury, there was no statistically significant difference in infection rate or cosmetic outcome. 

Source
Effectiveness of nail bed repair in children with or without replacing the fingernail: NINJA multicentre randomized clinical trial. Br J Surg. 2023 Mar 30;110(4):432-438. doi: 10.1093/bjs/znad031.

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Cauda equina syndrome (CES) is a spinal emergency. This is a practical guide for diagnosis and management as well as review of recent literature published on the topic.

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Opioid pain medications offer no benefit compared to placebo for patients with acute back or neck pain.

Source
Opioid analgesia for acute low back pain and neck pain (the OPAL trial): a randomised placebo-controlled trial. Lancet. 2023 Jun 27:S0140-6736(23)00404-X. doi: 10.1016/S0140-6736(23)00404-X. Epub ahead of print.

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In a meta-analysis of 1,685 patients with suspected scaphoid fracture after negative plain radiographs, no clinical feature adequately rules out occult fracture.   

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This meta-analysis found Boss-Holzach-Matter/Davos and FARES had the most favorable value for success rates, while both FARES and modified external rotation were more favorable in reduction times. FARES also had the most favorable score for pain during reduction. 

Source
A Systematic Review With Pairwise and Network Meta-analysis of Closed Reduction Methods for Anterior Shoulder Dislocation. Annals of emergency medicine vol. 81,4 (2023): 453-465. doi:10.1016/j.annemergmed.2022.10.020 

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Bacteremia is common in pediatric patients who present to the ED with fever and acute lower extremity pain. Obtain a blood cultures in these patients, as it is likely to assist in diagnosis or change management, particularly if they also have a higher fever, focal bony tenderness, or an elevated CRP. 

Source
Bacteremia in Children With Fever and Acute Lower Extremity Pain. Pediatrics. 2023 Apr 4;e2022059504. doi: 10.1542/peds.2022-059504. Online ahead of print.

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The authors describe a novel reduction method for posterior hip dislocations using a hydraulic lift to apply longitudinal traction on the upper leg.