ACP, AAFP Issue Guidelines for Acute Musculoskeletal Injuries

TUESDAY, Aug. 18, 2020 (HealthDay News) — Topical nonsteroidal anti-inflammatory drugs (NSAIDs) are recommended for the treatment of acute pain from non-low back, musculoskeletal injuries, according to a clinical guideline developed by the American College of Physicians (ACP) and the American Academy of Family Physicians (AAFP) and published online Aug. 18 in the Annals of Internal Medicine.

Amir Qaseem, M.D., Ph.D., from the American College of Physicians in Philadelphia, and colleagues developed guidelines for nonpharmacologic and pharmacologic management of acute pain from non-low back, musculoskeletal injuries in adult outpatients. Evidence was included from two systematic reviews that compared the effectiveness of outpatient treatments and explored predictors of persistent opioid use.

The authors recommend that acute pain from non-low back, musculoskeletal injuries should be treated with topical NSAIDs with or without menthol gel as first-line therapy to reduce or relieve symptoms. The ACP and AAFP suggest that oral NSAIDs should be used to reduce or relieve symptoms for patients with acute pain from non-low back, musculoskeletal injuries; oral acetaminophen is suggested for reducing pain. Specific acupressure is suggested for reducing pain and improving physical function, while transcutaneous electrical nerve stimulation is suggested for reducing pain. Patients should be discouraged from using opioids, including tramadol, for treating acute pain.

“This guideline is not intended to provide a one-size-fits-all approach to managing non-low back pain,” Gary LeRoy, M.D., president of the AAFP, said in a statement. “Our main objective was to provide a sound and transparent framework to guide family physicians in shared decision making with patients.”

Clinical Guideline
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