The American College of Physicians (ACP) and American Academy of Family Physicians (AAFP) have developed a guideline providing recommendations on non-pharmacologic and medication management of acute pain from non–low back, musculoskeletal injuries in outpatient adults.
Recommendation 1:
Acute pain from non–low back, musculoskeletal injuries should be managed with topical nonsteroidal anti-inflammatory drugs (NSAIDs) with or without menthol gel as first-line therapy. The objectives should be to reduce or relieve pain; improve physical function; and improve the patient’s treatment satisfaction
Recommendation 2a:
Patients with acute pain from non–low back, musculoskeletal injuries can be treated with oral NSAIDs to reduce or relieve symptoms, including pain, and to improve physical function, or with oral paracetamol to reduce pain
Recommendation 2b:
Specific acupressure to reduce pain and improve physical function, or transcutaneous electrical nerve stimulation to reduce pain may also be used.
Recommendation 3:
ACP and AAFP suggest against clinicians treatment of acute pain from non–low back, musculoskeletal injuries with opioids, including tramadol