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Am Fam Physician. 2023;107(1):23-24

This clinical content conforms to AAFP criteria for CME.

Author disclosure: No relevant financial relationships.

Clinical Question

Are oral nonsteroidal anti-inflammatory drugs (NSAIDs) superior to other oral analgesics for the treatment of pain associated with acute soft tissue injuries?

Evidence-Based Answer

There is no difference in effectiveness between NSAIDs and other pain relievers, including acetaminophen and opioids, for pain reduction in patients younger than 65 years who have acute strains and sprains.1 (Strength of Recommendation: B, inconsistent or limited-quality patient-oriented evidence.)

Practice Pointers

More than 65 million health care visits for musculoskeletal injuries occur annually in the United States.2 NSAIDs are commonly recommended to reduce pain and inflammation related to these injuries, but they are associated with gastrointestinal, renal, and cardiovascular adverse effects.3,4 The authors of this Cochrane review sought to determine whether NSAIDs are superior to other agents for treating pain related to acute soft tissue injuries.

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These are summaries of reviews from the Cochrane Library.

This series is coordinated by Corey D. Fogleman, MD, assistant medical editor.

A collection of Cochrane for Clinicians published in AFP is available at

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