New guidelines for aches, pains, and strains – Harvard Health Blog

We’ve all been there before. A minor injury leads to a sore ankle, achy shoulder, or sore neck. You could do nothing, try to ignore it, and see if it gets better. Or you may be tempted to take something, especially if significant discomfort prevents you from doing your usual activities or keeps you up at night.

So, what’s the best initial treatment? For minor injuries, your options are many, including:

  • Home remedies. Common approaches are the “RICE” treatments — Rest, Ice, Compression, and Elevation: applying cold to the sore area, wearing an elastic wrap to compress the sore area, rest, and elevation (such as propping up your sore ankle on pillows).
  • Nondrug approaches. For instance, massage or acupuncture.
  • Pain medicines. Examples are acetaminophen, anti-inflammatory drugs like ibuprofen, or other pain relievers.

New guidelines have been developed

Recently, the American College of Physicians and American Academy of Family Physicians gathered experts to develop new recommendations for just this sort of situation. Officially, these guidelines are for “acute pain from non-low back, musculoskeletal injuries in adults” — that is, for people whose pain started less than four weeks ago and does not include low back pain (for which separate guidelines have been developed).

To come up with these recommendations, experts reviewed more than 200 randomized controlled trials, which are considered the highest quality and most powerful type of evidence. These trials enrolled nearly 33,000 subjects (average age 34) with a variety of conditions: the most common were sprains (especially involving the ankle), strains, and neck injuries. The researchers considered not only pain relief but also physical function, quality of life, patient satisfaction, return to work, and side effects.

What the new guidelines recommend

These new guidelines did not specifically comment on the standard home remedies of rest, ice, compression, and elevation,

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