AMPED Outcomes Registry of Post-ED Pain Management

Inclusion Criteria: * Eligible subjects will meet the following criteria: 1. Eligible diagnoses: musculoskeletal etiologies: acute extremity fractures sprains/strains acute gouty arthritis visceral etiologies: renal colic dysmenorrhea 2. Age GTE 18 years; 3. Decision to discharge from ED to community already made; 4. Decision to give SPRIX, opioid, OR SPRIX + opioid rescue already made; 5. Treating clinician deems patient appropriate for continued analgesic management as an outpatient for the next 3-5 days; 6. Patient has ready touch-tone (mobile or land line) telephone access, provides number (and back-up number, if possible) and agrees (verbal or written consent as mandated by site) to answer and comply with brief IVR questionnaires daily for next 4 days. Exclusion Criteria: * Eligible subjects will meet none of the following criteria: 1. Patient admitted or placed on observation status from ED; 2. Patient unwilling or unable to comply with telephonic follow-up; 3. Fracture that requires surgical repair (even if at a later date); 4. Patient has diagnosis of any chronic pain syndrome; 5. Patient already routinely takes NSAID or opioid agent; 6. Treating clinician has reasonable suspicion of drug-seeking behavior or noncompliance; 7. Nasal abnormality or illness that could affect the absorption of intranasal medication (such as: nasal discharge, rhinitis, acute upper respiratory infection, acute epistaxis, nasal polyp, nasal tumor).