A 40-year-old patient presents to your outpatient clinic wit…

A 40-year-old patient presents to your outpatient clinic with fever, diffuse headache, photophobia, and neck discomfort. Neurologic screening is nonfocal. You plan a focused bedside examination to evaluate for meningeal irritation. Which maneuver is most appropriate to perform now?

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?