Efficacy of PENNSAID® for Pain Management in the Emergency Department

Inclusion: -We will include ED patients presenting with an acutely painful ankle sprain for which NSAIDs constitute standard of care pain management. The following will be excluded: * Those with lacerations, bites, burns * any head trauma * pregnant * anyone with a pre-existing chronic pain condition * inflammatory intestinal disorders such as Crohn's disease or ulcerative colitis * anyone regularly using another NSAID or anti-coagulation medication * anyone who has experienced asthma after NSAID use * compromised cognitive abilities * a significant co-morbidity that will compromise participation * had joint replacements * known hypersensitivity to diclofenac or allergic responses to NSAIDs as a class * active stomach and/or duodenal ulceration or gastrointestinal bleeding * anyone admitted with severe active bleeding * recent heart surgery * severe liver or renal insufficiency * prisoner * mentally disabled patients * wards of the state * cognitive or decisional impairment