Nonpharmacologic and Pharmacologic Management of Acute Pain From Non–Low Back, Musculoskeletal Injuries in Adults
Authors: Jason W. Busse, Devan L. Kansagara, Kenneth Lin, David O’Gurek, Amir Qaseem
Journal: Annals of Internal Medicine (2021)

LettersMay 2021Nonpharmacologic and Pharmacologic Management of Acute Pain From Non–Low Back, Musculoskeletal Injuries in AdultsJason W. Busse, DC, PhD, Devan L. Kansagara, MD, MCR, Kenneth Lin, MD, David O'Gurek, MD, Amir Qaseem, MD, PhD, MHAJason W. Busse, DC, PhDMcMaster University and the Chronic Pain Centre of Excellence for Canadian Veterans, Hamilton, Ontario, Canada, Devan L. Kansagara, MD, MCRPortland VA Medical Center, Portland, Oregon, Kenneth Lin, MDGeorgetown University Medical Center, Washington, DC, David O'Gurek, MDLewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, Amir Qaseem, MD, PhD, MHAAmerican College of Physicians, Philadelphia, PennsylvaniaAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L21-0061 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE: We thank Dr. Mathieson and colleagues for their comment. Guidelines are "guides" only and may not apply to all patients and clinical situations (1, 2). Thus, clinical guidelines are not intended to override clinicians' judgments. We disagree with Dr. Mathieson and colleagues and believe that the interventions can be compared across the clinical indications. The effect of the interventions on outcomes is comparable across musculoskeletal injuries. The biology of the experience of pain in such conditions is similar; therefore, we can expect similar effects of interventions directed at pain relief. When provided with the list of patient-reported pain ...References1. Qaseem A, McLean RM, O'Gurek D, et al. Nonpharmacologic and pharmacologic management of acute pain from non-low back, musculoskeletal injuries in adults: a clinical guideline from the American College of Physicians and American Academy of Family Physicians. Ann Intern Med. 2020;173:739-48. [PMID: 32805126]. doi:10.7326/M19-3602 LinkGoogle Scholar2. Busse JW, Sadeghirad B, Oparin Y, et al. Management of acute pain from non-low back, musculoskeletal injuries: a systematic review and network meta-analysis of randomized trials. Ann Intern Med. 2020;173:730-8. [PMID: 32805127]. doi:10.7326/M19-3601 LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: McMaster University and the Chronic Pain Centre of Excellence for Canadian Veterans, Hamilton, Ontario, CanadaPortland VA Medical Center, Portland, OregonGeorgetown University Medical Center, Washington, DCLewis Katz School of Medicine at Temple University, Philadelphia, PennsylvaniaAmerican College of Physicians, Philadelphia, PennsylvaniaDisclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-3602. A record of disclosures of interest and management of conflicts of is kept for each Clinical Guidelines Committee meeting and conference call and can be viewed at www.acponline.org/clinical_information/guidelines/guidelines/conflicts_cgc.htm. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoNonpharmacologic and Pharmacologic Management of Acute Pain From Non–Low Back, Musculoskeletal Injuries in Adults: A Clinical Guideline From the American College of Physicians and American Academy of Family Physicians Amir Qaseem , Robert M. McLean , David O'Gurek , Pelin Batur , Kenneth Lin , Devan L. Kansagara , and Nonpharmacologic and Pharmacologic Management of Acute Pain From Non–Low Back, Musculoskeletal Injuries in Adults Stephanie Mathieson , Matthew K. Bagg , Mark Schoene , and Christopher G. Maher Metrics May 2021Volume 174, Issue 5Page: 733 ePublished: 18 May 2021 Issue Published: May 2021 Copyright & PermissionsCopyright © 2021 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...