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Treating Pain from Common Musculoskeletal Conditions

Here are the recommendations from the American Academy of Family Physicians as well as the American College of Physicians on how to treat pain from common musculoskeletal conditions. This is targeted towards non low back pain.

Recommendation 1: Use topical non-steroidal anti-inflammatory medications as first line therapy. Grade: strong recommendation, moderate evidence.

Topical non-steroidal anti-inflammatory medications include voltaren (diclofenac) gel. It is available over the counter or with a physician’s prescription.

Prolonged use of oral non-steroidal anti-inflammatory medications have risk of systemic side effects. These medications include aspirin, ibuprofen (Advil), naproxen (Aleve), meloxicam (mobic), diclofenac (Voltaren) etc. They can affect the stomach lining, the kidneys, the heart, blood pressure, and much more.

Topical non-steroidal anti-inflammatory medications may provide pain relief without the negative systemic effects of their oral counterparts.

Recommendation 2: Use oral non-steroidal anti-inflammatory medications or tylenol to treat pain. Consider using acupressure or transcutaneous electrical nerve stimulation (TENS) units to reduce pain. Grade: low certainty evidence.

Acupressure and TENS units are soft tissue modalities. They are among many myofascial release techniques used to treat musculoskeletal pain. Trigger points are an extremely common cause of musculoskeletal pain, many of which can be addressed by myofascial release. Other common modalities include using a theracane or a foam roller.

Recommendation 3: Avoid using opioids. Grade: low certainty evidence.

100% agree. Avoid narcotics unless truly necessary.

See here for the full recommendations:


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