Clinical recommendation	Evidence rating	Comments
Topical nonsteroidal anti-inflammatory drugs are safe and effective for treating acute pain.18,19,20	A	Systematic review, consistent randomized controlled trials, evidence-based guidelines
Nonsteroidal anti-inflammatory drugs, acetaminophen, or a combination is an effective initial treatment approach for acute pain syndromes. Medication selection should be based on minimizing risks for the specific patient.13,17,23,25	A	Systematic reviews, consistent randomized controlled trials, clinical guidelines
Muscle relaxants are effective adjunctive medications for acute low back pain and neck pain.43,44	B	Systematic review, multiple randomized controlled trials
Gabapentinoids and antidepressant medications used to treat chronic neuropathic pain should not be used to treat acute pain.53–56	B	Meta-analysis (gabapentinoids), systematic review (gabapentinoids and antidepressants), mixed results from high-quality studies (gabapentinoids)
Cannabinoids used to treat chronic neuropathic pain should not be used to treat acute pain.60	C	Mixed results from low-quality studies
Opioids should be used for no more than three days, only for severe or refractory acute pain, and only in combination with other medications.12,17,25,63,64	C	Expert consensus opinion, clinical guidelines