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Low back pain conservative management

2026-04-12T19:23:54Z

Mckenzie Method

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	According to a [[systematic review]] of [[randomized controlled trial]]s by the [[Cochrane Collaboration]], massage therapy, compared to inactive controls, over the short-term significantly reduced pain (SMD=0.75; large) and improved function (SMD=0.72; large).<ref name="pmid26329399">{{cite journal\| author=Furlan AD, Giraldo M, Baskwill A, Irvin E, Imamura M\| title=Massage for low-back pain. \| journal=Cochrane Database Syst Rev \| year= 2015 \| volume= 9 \| issue= \| pages= CD001929 \| pmid=26329399 \| doi=10.1002/14651858.CD001929.pub3 \| pmc= \| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26329399 }} </ref> However, the Cochrane concluded "very little confidence that massage is an effective treatment".		According to a [[systematic review]] of [[randomized controlled trial]]s by the [[Cochrane Collaboration]], massage therapy, compared to inactive controls, over the short-term significantly reduced pain (SMD=0.75; large) and improved function (SMD=0.72; large).<ref name="pmid26329399">{{cite journal\| author=Furlan AD, Giraldo M, Baskwill A, Irvin E, Imamura M\| title=Massage for low-back pain. \| journal=Cochrane Database Syst Rev \| year= 2015 \| volume= 9 \| issue= \| pages= CD001929 \| pmid=26329399 \| doi=10.1002/14651858.CD001929.pub3 \| pmc= \| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26329399 }} </ref> However, the Cochrane concluded "very little confidence that massage is an effective treatment".

	===~~Mckenzie Method~~===		=== Physical Therapy===
	The Mckenzie Method has been shown to be a modestly effective therapy for adults with chronic low back pain. A 2011 summary of 4 studies showed consistent significant improvement in pain and function although only one study had a large enough population to demonstrate effect sizes on pain and functional outcomes, 0.50 and 0.39 respectively.<ref name="pmid22135496">{{cite journal\| author=Dunsford A, Kumar S, Clarke S\| title=Integrating evidence into practice: use of McKenzie-based treatment for mechanical low back pain. \| journal=J Multidiscip Healthc \| year= 2011 \| volume= 4 \| issue= \| pages= 393-402 \| pmid=22135496 \| doi=10.2147/JMDH.S24733 \| pmc=PMC3215349 \| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22135496 }} </ref>		The Mckenzie Method has been shown to be a modestly effective therapy for adults with chronic low back pain. A 2011 summary of 4 studies showed consistent significant improvement in pain and function although only one study had a large enough population to demonstrate effect sizes on pain and functional outcomes, 0.50 and 0.39 respectively.<ref name="pmid22135496">{{cite journal\| author=Dunsford A, Kumar S, Clarke S\| title=Integrating evidence into practice: use of McKenzie-based treatment for mechanical low back pain. \| journal=J Multidiscip Healthc \| year= 2011 \| volume= 4 \| issue= \| pages= 393-402 \| pmid=22135496 \| doi=10.2147/JMDH.S24733 \| pmc=PMC3215349 \| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22135496 }} </ref>

			A randomized controlled trail in 2015 found minimal benefit.<ref name="v851">{{cite journal \| last1=Fritz \| first1=Julie M. \| last2=Magel \| first2=John S. \| last3=McFadden \| first3=Molly \| last4=Asche \| first4=Carl \| last5=Thackeray \| first5=Anne \| last6=Meier \| first6=Whitney \| last7=Brennan \| first7=Gerard \| title=Early Physical Therapy vs Usual Care in Patients With Recent-Onset Low Back Pain: A Randomized Clinical Trial \| journal=JAMA \| volume=314 \| issue=14 \| date=2015-10-13 \| issn=0098-7484 \| doi=10.1001/jama.2015.11648 \| page=1459 \| url=http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2015.11648 \| access-date=2026-04-12}}</ref>

	===Pilates===		===Pilates===

Back pain

2026-04-12T19:14:31Z

Treatment

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	==Treatment==		==Treatment==

	[[Back pain medical therapy\|Medical Therapy]] \| [[Back pain surgery\|Surgery]] \| [[Back pain primary prevention\|Primary Prevention]] \| [[Back pain secondary prevention\|Secondary Prevention]] \| [[Back pain cost-effectiveness of therapy\|Cost-Effectiveness of Therapy]] \| [[Back pain future or investigational therapies\|Future or Investigational Therapies]] \| [[Back pain monitoring response to therapy\| Monitoring Response to Therapy]]		[[Back pain medical therapy\|Medical Therapy]] \| [[Low back pain conservative management]] \| [[Back pain surgery\|Surgery]] \| [[Back pain primary prevention\|Primary Prevention]] \| [[Back pain secondary prevention\|Secondary Prevention]] \| [[Back pain cost-effectiveness of therapy\|Cost-Effectiveness of Therapy]] \| [[Back pain future or investigational therapies\|Future or Investigational Therapies]] \| [[Back pain monitoring response to therapy\| Monitoring Response to Therapy]]

	==Lecture==		==Lecture==

File:Zoliflodacin.jpg

2026-04-11T14:35:03Z

Basir Gill uploaded File:Zoliflodacin.jpg

New page

Template:SS

2026-04-09T17:52:01Z

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	[[User:~~ShiSheng~~\|~~Sheng Shi~~, ~~M.D.~~]] [mailto:~~shengshi~~@~~wikidoc~~.~~org~~]		[[User:Sophia Saad\|Sophia Saad, Associate Editor - WikiDoc]] [mailto:scsaad23@yahoo.com]

Olezarsen

2026-04-08T08:33:21Z

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Cosibelimab-ipdl

2026-04-08T08:32:42Z

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User:Nehal Eid

2026-04-08T08:28:46Z

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	[[User:Nehal Eid\|Nehal Eid, M.D.]][mailto:nehalelsaeed98@gmail.com]		[[User:Nehal Eid\|Nehal Eid, M.D.]][mailto:nehalelsaeed98@gmail.com]

			'''Wikidoc contributions:'''

			[[Juvenile idiopathic arthritis]]

			[[Sudden cardiac death]]

			[[Cosibelimab-ipdl]]

			[[Olezarsen]]

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Sudden cardiac death prognosis

2026-04-07T15:45:12Z

Prognosis of cardiac arrest in young athletes:

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	==== Prognosis of cardiac arrest in young athletes: ====		==== Prognosis of cardiac arrest in young athletes: ====

			* 58% survival rate was reported by the US Commotio Cordis Registry in 216 persons with sudden cardiac arrest due to commotio cordis (cardiac arrest due to VF triggered by blunt chest trauma) (age range, 0.2-51 years;mean,15years, 95% male) from 2006 through 2012.<ref name=":9">Maron BJ, Haas TS, Ahluwalia A, Garberich RF, Estes NA III, Link MS. Increasing survival rate from commotio cordis.HeartRhythm.2013;10(2):219-223. doi:10.1016/j.hrthm.2012.10.034</ref>
			* Prompt resuscitation and participation in organized competitive sports was associated with higher survival rates. Multivariate analysis identified participation in recreational sports with lower survival (odds ratio [OR] compared with organized competitive sports, 0.33; 95%CI,0.16-0.67) and onsite automated external defibrillator with higher survival (OR, 4.61; 95% CI, 1.43-14.88).<ref name=":9" />
			* Individuals aged 18 to 35 years with sports-related sudden cardiac arrest in Germany and France showed improved survival to hospital discharge with public automated external defibrillator use prior to EMS arrival (OR, 6.25; 95% CI, 1.48 43.20); individuals with sudden cardiac arrest who received both immediate bystander CPR and automated external defibrillator had 91%survival.<ref>Bohm P, Meyer T, Narayanan K, et al. Sports-related sudden cardiac arrest in young adults. Europace. 2023;25(2):627-633. doi:10.1093/ europace/euac172</ref>
			* A recent meta-analysis demonstrated that in sports related sudden cardiac arrest, bystander presence (OR, 2.55; 95%CI, 1.48-4.37), bystander CPR (OR, 3.84; 95% CI, 2.36-6.25), and bystander automated external defibrillator use (OR, 5.25; 95%CI,3.58-7.70) were associated with improved survival.<ref>Michelland L, Murad MH, Bougouin W, et al. Association between basic life support and survival in sports-related sudden cardiac arrest: a meta-analysis. Eur Heart J. 2023;44(3):180-192. doi:10.1093/eurheartj/ehac586</ref>

	==References==		==References==

Sudden cardiac death epidemiology and demographics

2026-04-07T15:38:11Z

Cardiac arrest in young athletes:

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	* Commotio cordis is cardiac arrest precipitated by chest blunt force sufficient to trigger VF.<ref>Maron BJ, Estes NA III. Commotio cordis. N Engl J Med. 2010;362(10):917-927.doi:10.1056/ NEJMra0910111</ref>,<ref>Peng T, Derry LT, Yogeswaran V, Goldschlager NF. Commotio cordis in 2023. SportsMed.2023;53 (8):1527-1536. doi:10.1007/s40279-023-01873-6</ref> Although commotio cordis incidence is unknown, more than 90% of cases in the US occur among individuals younger than 25 years.<ref name=":8">Maron BJ, Ahluwalia A, Haas TS, Semsarian C, Link MS, Estes NA III. Global epidemiology and JAMA March18,2025 Volume 333,Number11 (Reprinted) demographics of commotio cordis. HeartRhythm. 2011;8(12):1969-1971. doi:10.1016/j.hrthm.2011.07. 014</ref> Commotio cordis is common in baseball, softball, and football in the US, whereas soccer, cricket, and hockey were the sports most commonly associated with it in non-US populations.<ref name=":8" />		* Commotio cordis is cardiac arrest precipitated by chest blunt force sufficient to trigger VF.<ref>Maron BJ, Estes NA III. Commotio cordis. N Engl J Med. 2010;362(10):917-927.doi:10.1056/ NEJMra0910111</ref>,<ref>Peng T, Derry LT, Yogeswaran V, Goldschlager NF. Commotio cordis in 2023. SportsMed.2023;53 (8):1527-1536. doi:10.1007/s40279-023-01873-6</ref> Although commotio cordis incidence is unknown, more than 90% of cases in the US occur among individuals younger than 25 years.<ref name=":8">Maron BJ, Ahluwalia A, Haas TS, Semsarian C, Link MS, Estes NA III. Global epidemiology and JAMA March18,2025 Volume 333,Number11 (Reprinted) demographics of commotio cordis. HeartRhythm. 2011;8(12):1969-1971. doi:10.1016/j.hrthm.2011.07. 014</ref> Commotio cordis is common in baseball, softball, and football in the US, whereas soccer, cricket, and hockey were the sports most commonly associated with it in non-US populations.<ref name=":8" />
	* 58% survival rate was reported by the US Commotio Cordis Registry in 216 persons with sudden cardiac arrest due to commotio cordis (age range, 0.2-51 years;mean,15years,95%male) from 2006 through 2012.<ref name=":9">Maron BJ, Haas TS, Ahluwalia A, Garberich RF, Estes NA III, Link MS. Increasing survival rate from commotio cordis.HeartRhythm.2013;10(2):219-223. doi:10.1016/j.hrthm.2012.10.034</ref>
	* Prompt resuscitation and participation in organized competitive sports was associated with higher survival rates. Multivariate analysis identified participation in recreational sports with lower survival (odds ratio [OR] compared with organized competitive sports, 0.33; 95%CI,0.16-0.67) and onsite automated external defibrillator with higher survival (OR, 4.61; 95% CI, 1.43-14.88).<ref name=":9" />
	*

	==References==		==References==

Sudden cardiac death prognosis

2026-04-07T15:37:06Z

Prognosis of Sudden Cardiac Arrest Survivors

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	:* Women between 15-45 years old<ref name="pmid20228684">{{cite journal \|vauthors=Topjian AA, Localio AR, Berg RA, Alessandrini EA, Meaney PA, Pepe PE, Larkin GL, Peberdy MA, Becker LB, Nadkarni VM \|title=Women of child-bearing age have better inhospital cardiac arrest survival outcomes than do equal-aged men \|journal=Crit Care Med \|volume=38 \|issue=5 \|pages=1254–60 \|date=May 2010 \|pmid=20228684 \|pmc=3934212 \|doi=10.1097/CCM.0b013e3181d8ca43 \|url=}}</ref>		:* Women between 15-45 years old<ref name="pmid20228684">{{cite journal \|vauthors=Topjian AA, Localio AR, Berg RA, Alessandrini EA, Meaney PA, Pepe PE, Larkin GL, Peberdy MA, Becker LB, Nadkarni VM \|title=Women of child-bearing age have better inhospital cardiac arrest survival outcomes than do equal-aged men \|journal=Crit Care Med \|volume=38 \|issue=5 \|pages=1254–60 \|date=May 2010 \|pmid=20228684 \|pmc=3934212 \|doi=10.1097/CCM.0b013e3181d8ca43 \|url=}}</ref>
	:*Rapid intervention with a [[defibrillator]] increases [[survival rates]].<ref>{{cite journal \|author=Eisenberg MS, Mengert TJ \|title=Cardiac resuscitation \|journal=N. Engl. J. Med. \|volume=344 \|issue=17 \|pages=1304–13 \|year=2001 \|month=April \|pmid=11320390 \|doi= \|url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=11320390&promo=ONFLNS19}}</ref><ref name="pmid12826637">{{cite journal \|author=Bunch TJ, White RD, Gersh BJ, ''et al'' \|title=Long-term outcomes of out-of-hospital cardiac arrest after successful early defibrillation \|journal=N. Engl. J. Med. \|volume=348 \|issue=26 \|pages=2626–33 \|year=2003 \|month=June \|pmid=12826637 \|doi=10.1056/NEJMoa023053 \|url=}}</ref>		:*Rapid intervention with a [[defibrillator]] increases [[survival rates]].<ref>{{cite journal \|author=Eisenberg MS, Mengert TJ \|title=Cardiac resuscitation \|journal=N. Engl. J. Med. \|volume=344 \|issue=17 \|pages=1304–13 \|year=2001 \|month=April \|pmid=11320390 \|doi= \|url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=11320390&promo=ONFLNS19}}</ref><ref name="pmid12826637">{{cite journal \|author=Bunch TJ, White RD, Gersh BJ, ''et al'' \|title=Long-term outcomes of out-of-hospital cardiac arrest after successful early defibrillation \|journal=N. Engl. J. Med. \|volume=348 \|issue=26 \|pages=2626–33 \|year=2003 \|month=June \|pmid=12826637 \|doi=10.1056/NEJMoa023053 \|url=}}</ref>

			==== Prognosis of cardiac arrest in young athletes: ====

	==References==		==References==

Sudden cardiac death epidemiology and demographics

2026-04-07T15:35:25Z

Race

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	*In a US study from 1999 through 2015 (n = 31492), Black individuals younger than 34 years had a higher incidence of presumed sudden cardiac deaths (1.88 per 100000 person-years in 2015) than Hispanic individuals (0.66 per 100000 person-years),and White individuals (1.17 per 100000 person-years),<ref>El-AssaadI, Al-Kindi SG, Aziz PF. Trends of out-of-hospital sudden cardiac death among children and youngadults. Pediatrics. 2017;140(6): e20171438. doi:10.1542/peds.2017-1438</ref> which may be due to inequitable access to care <ref>Noonan AS, Velasco-Mondragon HE, Wagner FA. Improving the health of African Americans in the USA: an overdue opportunity for social justice. Public Health Rev. 2016;37:12. doi:10. 1186/s40985-016-0025-4</ref> and racial disparities among out-of hospital resuscitation attempts.		*In a US study from 1999 through 2015 (n = 31492), Black individuals younger than 34 years had a higher incidence of presumed sudden cardiac deaths (1.88 per 100000 person-years in 2015) than Hispanic individuals (0.66 per 100000 person-years),and White individuals (1.17 per 100000 person-years),<ref>El-AssaadI, Al-Kindi SG, Aziz PF. Trends of out-of-hospital sudden cardiac death among children and youngadults. Pediatrics. 2017;140(6): e20171438. doi:10.1542/peds.2017-1438</ref> which may be due to inequitable access to care <ref>Noonan AS, Velasco-Mondragon HE, Wagner FA. Improving the health of African Americans in the USA: an overdue opportunity for social justice. Public Health Rev. 2016;37:12. doi:10. 1186/s40985-016-0025-4</ref> and racial disparities among out-of hospital resuscitation attempts.
	*White individuals were more likely to receive bystander CPR after a witnessed cardiac arrest and postresuscitation care than were Black and Hispanic persons in several US based studies.<ref>Toy J, Bosson N, Schlesinger S,Gausche-Hill M. Racial and ethnic disparities in the provision of bystander CPR after witnessed out-of-hospital cardiac arrest in the United States. Resuscitation. 2023;190:109901. doi:10.1016/j.resuscitation.2023. 109901</ref><ref>Casey SD, Mumma BE.Sex,race,and insurance status differences in hospital treatment and outcomes following out-of-hospital cardiac arrest. Resuscitation. 2018;126:125-129. doi:10.1016/j. resuscitation.2018.02.027</ref>		*White individuals were more likely to receive bystander CPR after a witnessed cardiac arrest and postresuscitation care than were Black and Hispanic persons in several US based studies.<ref>Toy J, Bosson N, Schlesinger S,Gausche-Hill M. Racial and ethnic disparities in the provision of bystander CPR after witnessed out-of-hospital cardiac arrest in the United States. Resuscitation. 2023;190:109901. doi:10.1016/j.resuscitation.2023. 109901</ref><ref>Casey SD, Mumma BE.Sex,race,and insurance status differences in hospital treatment and outcomes following out-of-hospital cardiac arrest. Resuscitation. 2018;126:125-129. doi:10.1016/j. resuscitation.2018.02.027</ref>

			=== Cardiac arrest in young athletes: ===

			* Commotio cordis is cardiac arrest precipitated by chest blunt force sufficient to trigger VF.<ref>Maron BJ, Estes NA III. Commotio cordis. N Engl J Med. 2010;362(10):917-927.doi:10.1056/ NEJMra0910111</ref>,<ref>Peng T, Derry LT, Yogeswaran V, Goldschlager NF. Commotio cordis in 2023. SportsMed.2023;53 (8):1527-1536. doi:10.1007/s40279-023-01873-6</ref> Although commotio cordis incidence is unknown, more than 90% of cases in the US occur among individuals younger than 25 years.<ref name=":8">Maron BJ, Ahluwalia A, Haas TS, Semsarian C, Link MS, Estes NA III. Global epidemiology and JAMA March18,2025 Volume 333,Number11 (Reprinted) demographics of commotio cordis. HeartRhythm. 2011;8(12):1969-1971. doi:10.1016/j.hrthm.2011.07. 014</ref> Commotio cordis is common in baseball, softball, and football in the US, whereas soccer, cricket, and hockey were the sports most commonly associated with it in non-US populations.<ref name=":8" />
			* 58% survival rate was reported by the US Commotio Cordis Registry in 216 persons with sudden cardiac arrest due to commotio cordis (age range, 0.2-51 years;mean,15years,95%male) from 2006 through 2012.<ref name=":9">Maron BJ, Haas TS, Ahluwalia A, Garberich RF, Estes NA III, Link MS. Increasing survival rate from commotio cordis.HeartRhythm.2013;10(2):219-223. doi:10.1016/j.hrthm.2012.10.034</ref>
			* Prompt resuscitation and participation in organized competitive sports was associated with higher survival rates. Multivariate analysis identified participation in recreational sports with lower survival (odds ratio [OR] compared with organized competitive sports, 0.33; 95%CI,0.16-0.67) and onsite automated external defibrillator with higher survival (OR, 4.61; 95% CI, 1.43-14.88).<ref name=":9" />
			*

	==References==		==References==

Sudden cardiac death screening

2026-04-07T15:15:15Z

Screening in young athletes:

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	**VA calculator		**VA calculator

			=== Screening in young athletes: ===
			The American Heart Association–American College of Cardiology consensus statement<ref name=":1">Maron BJ, Levine BD, Washington RL, Baggish AL, Kovacs RJ, Maron MS; American Heart Association Electrocardiography and Arrhythmias Committee of Council on Clinical Cardiology, Council on Cardiovascular Disease in Young, Council on Cardiovascular and Stroke Nursing, Council on Functional Genomics and Translational Biology, and American College of Cardiology. Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: Task Force 2: preparticipation screening for cardiovascular disease in competitive athletes: a scientific statement from the American Heart Association and AmericanCollege of Cardiology. Circulation. 2015;132(22):e267-e272.</ref> on preparticipation screening recommends the American Heart Association 14-point screening guide, including a comprehensive history taking and a physical examination for young athletes (class I recommendation), but does not recommend routine ECG screening of young adults (athletes and non-athletes) in the general population (class III), due to concerns about diagnostic accuracy, cost-effectiveness, and availability of physicians and equipment needed for screening. ECG or transthoracic echocardiography should only be performed in select individuals in whom genetic,congenital,or other cardiovascular abnormalities are suspected or identified (class IIb).<ref name=":1" />

			However, recent ESC guideline recommends a 12-lead ECG as part of preparticipation for all competitive athletes younger than 35 years (class IIa).<ref name="pmid36017572" /> This recommendation was supported by outcome data from the Veneto region, which showed declining incidence of sudden death in young competitive athletes after introduction of a nationwide prescreening program using ECG.<ref>Corrado D, Basso C, Pavei A, Michieli P, Schiavon M,ThieneG. Trends in sudden cardiovascular death in young competitive athletes after implementation of a preparticipation screening program. JAMA.2006;296(13):1593-1601. doi:10.1001/jama.296.13.1593</ref> Some data suggest that compared with history and physical examination, ECG may provide superior accuracy to identify potential risk of sudden death, primarily due to detection of preexcitation syndromes (sensitivity 88% vs 19%, specificity 98% vs 75%).<ref>Williams EA, Pelto HF, Toresdahl BG, et al. Performance of the American Heart Association (AHA)14-point evaluation versus electrocardiography for the cardiovascular screening of high school athletes: a prospective 996 study. J AmHeartAssoc.2019;8(14):e012235. doi:10.1161/JAHA.119.012235</ref>,<ref>Goff NK, Hutchinson A, Koek W, Kamat D. Meta-analysis on the effectiveness of ECG screening for conditions related to sudden cardiac death in young athletes. Clin Pediatr (Phila). 2023;62(10):1158-1168. doi:10.1177/ 00099228231152857</ref>

			In the last 2 decades, preparticipation screening for early identification of young competitive athletes at risk of sudden cardiac arrest in high school, college, and professional settings has been investigated. A comparable incidence of cardiovascular deaths was found between 1993 and 2015 in these studies screening competitive athletes. In the Veneto region of Italy, where ECG is routinely employed as part of preparticipation screening, and those in the US (Minnesota), where preparticipation prescreening is limited to history and physical examination.<ref>Maron BJ, Haas TS, Doerer JJ, Thompson PD, Hodges JS. Comparison of U.S.and Italian experiences with sudden cardiac deaths in young competitive athletes and implications for preparticipation screening strategies. Am J Cardiol. 2009;104(2):276-280. doi:10.1016/j.amjcard.2009. 03.037</ref>