A Randomized Trial of NSAID Dosing Strategies

Inclusion Criteria: * Acute musculoskeletal pain: Any pain attributable to muscles, bones, joints, tendons, ligaments or supporting structures, as determined by the clinical team, of 10 days duration or less. Prior to the onset of acute pain, patients cannot have experienced pain in the same body region during the prior six months * Pain has to be described as moderate or severe, when the patient is asked if the pain is mild, moderate or severe in intensity Exclusion Criteria: * Contraindication to NSAIDs (allergy to NSAID or allergy to aspirin without history of tolerating NSAIDs, history of gastrointestinal bleeding, daily medication for gastritis or PUD, chronic kidney disease 2-5, heart failure) * Contraindication to acetaminophen (hepatitis or cirrhosis) * Use of an NSAID within the previous eight hours * Use of acetaminophen within the previous eight hours * Chronic pain, defined as any pain on \>50% of days for at least 3 months prior to onset of acute pain * Recurrent pain in the same body part as the presenting complaint