Treatments for Acute Pain

In this systematic review, the Agency for Healthcare Research and Quality (AHRQ) evaluated the effectiveness and comparative effectiveness of opioid, nonopioid pharmacologic, and nonpharmacologic therapy in patients with specific types of acute pain, including effects on pain, function, quality of life, adverse events, and long-term use of opioids.

Researchers found that:

• Opioid therapy was associated with decreased or similar effectiveness as an NSAID for some acute pain conditions, but with increased risk of short-term adverse events
• Evidence on nonpharmacological therapies was limited, but heat therapy, spinal manipulation, massage, acupuncture, acupressure, a cervical collar, and exercise were effective for specific acute pain conditions

More research is needed to determine:

• The comparative effectiveness of therapies for sickle cell pain, acute neuropathic pain, neck pain, and management of postoperative pain following discharge
• The effects of therapies for acute pain on non-pain outcomes
• The effects of therapies on long-term outcomes, including long-term opioid use
• How benefits and harms of therapies vary in subgroups