acetaminophen and Sprains and Strains studies

Acetaminophen: Analgesic antipyretic derivative of acetanilide. It has weak anti-inflammatory properties and is used as a common analgesic, but may cause liver, blood cell, and kidney damage.
paracetamol : A member of the class of phenols that is 4-aminophenol in which one of the hydrogens attached to the amino group has been replaced by an acetyl group.

Sprains and Strains: A collective term for muscle and ligament injuries without dislocation or fracture. A sprain is a joint injury in which some of the fibers of a supporting ligament are ruptured but the continuity of the ligament remains intact. A strain is an overstretching or overexertion of some part of the musculature.

Research Excerpts

Excerpt	Relevance	Reference
"According to these results, diclofenac and paracetamol had the same effect on pain reduction of ankle sprains but more acute ankle edema was present in patients who were treated with diclofenac than in patients who were treated with paracetamol."	9.15	Efficacy of paracetamol versus diclofenac for Grade II ankle sprains. ( Lyrtzis, C; Natsis, K; Noussios, G; Papadopoulos, C; Papathanasiou, E, 2011)
"To compare acetaminophen extended release 1,300 mg 3 times daily and ibuprofen 400 mg 3 times daily for treatment of signs and symptoms of grade I or II lateral ankle sprains."	9.12	Randomized controlled noninferiority trial to compare extended release acetaminophen and ibuprofen for the treatment of ankle sprains. ( Dalton, JD; Schweinle, JE, 2006)
"It was concluded that diclofenac sodium and paracetamol are effective and well tolerated as a short term treatment alternatives for acute ankle injuries."	9.12	The efficacy of paracetamol in the treatment of ankle sprains in comparison with diclofenac sodium. ( Agus, H; Kayali, C; Surer, L; Turgut, A, 2007)
"Fifty college athletes with acute sprains and strains from football-related activities were randomly assigned to treatment with either diflunisal or acetaminophen with codeine for seven days."	9.06	Comparison of diflunisal and acetaminophen with codeine in the treatment of mild to moderate pain due to strains and sprains. ( Indelicato, PA, 1986)
"Diflunisal was found to be an effective analgesic in mild to moderate pain of acute soft tissue injuries, and caused fewer and more tolerable side effects than did acetaminophen with codeine."	6.66	Treatment of mild to moderate pain of acute soft tissue injury: diflunisal vs acetaminophen with codeine. ( DeForge, B; King, DE; Muncie, HL, 1986)
"According to these results, diclofenac and paracetamol had the same effect on pain reduction of ankle sprains but more acute ankle edema was present in patients who were treated with diclofenac than in patients who were treated with paracetamol."	5.15	Efficacy of paracetamol versus diclofenac for Grade II ankle sprains. ( Lyrtzis, C; Natsis, K; Noussios, G; Papadopoulos, C; Papathanasiou, E, 2011)
"To compare acetaminophen extended release 1,300 mg 3 times daily and ibuprofen 400 mg 3 times daily for treatment of signs and symptoms of grade I or II lateral ankle sprains."	5.12	Randomized controlled noninferiority trial to compare extended release acetaminophen and ibuprofen for the treatment of ankle sprains. ( Dalton, JD; Schweinle, JE, 2006)
"It was concluded that diclofenac sodium and paracetamol are effective and well tolerated as a short term treatment alternatives for acute ankle injuries."	5.12	The efficacy of paracetamol in the treatment of ankle sprains in comparison with diclofenac sodium. ( Agus, H; Kayali, C; Surer, L; Turgut, A, 2007)
"Subjects with moderate or greater wrist pain were randomized and stratified to 1 of the following treatments: efficacy evaluation (heat wrap, n=39; oral placebo, n=42) or blinding (oral acetaminophen, n=6; unheated wrap, n=6)."	5.11	Continuous low-level heat wrap therapy is effective for treating wrist pain. ( Erasala, GN; Hengehold, DA; Hun, L; Michlovitz, S; Weingand, KW, 2004)
"In a double-blind, placebo-controlled study the efficacy and safety of topical ketorolac tromethamine were assessed in the reduction of inflammation and pain due to ankle sprain."	5.06	A double-blind study of the efficacy of topical ketorolac tromethamine gel in the treatment of ankle sprain, in comparison to placebo and etofenamate. ( Bullingham, R; Diebschlag, W; Nocker, W, 1990)
"Fifty college athletes with acute sprains and strains from football-related activities were randomly assigned to treatment with either diflunisal or acetaminophen with codeine for seven days."	5.06	Comparison of diflunisal and acetaminophen with codeine in the treatment of mild to moderate pain due to strains and sprains. ( Indelicato, PA, 1986)
"A preliminary double-blind, randomized trial was carried out in general practice to compare the efficacy of treatment with diflunisal (500 mg) twice daily and a combination of dextropropoxyphene (65 mg) plus paracetemol (650 mg) 3-times daily for 3 days in relieving pain associated with strains and sprains."	5.04	A controlled study of diflunisal in sprains and strains. ( Grimshaw, JJ; Jaffé, GV; Roylance, PJ, 1978)
"Acute soft tissue injuries are common and costly."	2.66	Oral non-steroidal anti-inflammatory drugs versus other oral analgesic agents for acute soft tissue injury. ( Dalziel, SR; Jones, P; Lamdin, R, 2020)
"Diflunisal was found to be an effective analgesic in mild to moderate pain of acute soft tissue injuries, and caused fewer and more tolerable side effects than did acetaminophen with codeine."	2.66	Treatment of mild to moderate pain of acute soft tissue injury: diflunisal vs acetaminophen with codeine. ( DeForge, B; King, DE; Muncie, HL, 1986)
" The evidence was usually either low quality or very low quality, reflecting study limitations, indirectness such from as suboptimal dosing of single comparators, imprecision, or one or more of these."	2.52	Oral non-steroidal anti-inflammatory drugs versus other oral analgesic agents for acute soft tissue injury. ( Dalziel, SR; Frampton, C; Jones, P; Lamdin, R; Miles-Chan, JL, 2015)
"In this systematic review we present information relating to the benefits and harms of the following interventions: differences in efficacy among different oral NSAIDs, between oral and topical NSAIDs, and between oral NSAIDs and alternative analgesics; dose-response relationship of oral NSAIDs; and H(2) blockers, misoprostol, or proton pump inhibitors to mitigate gastrointestinal adverse effects of oral NSAIDs."	2.46	NSAIDs. ( Gøtzsche, PC, 2010)
"In this systematic review we present information relating to the benefits and harms of the following interventions: alternative analgesics, H(2) blockers, misoprostol, NSAIDs (systemic, topical, differences in efficacy between, dose-response relationship of), proton pump inhibitors."	2.44	NSAIDs. ( Gøtzsche, PC, 2007)

Research

Studies (23)

Authors

Clinical Trials (7)

Trial Overview

Trial Outcomes

Change From Baseline at Day 3 in Pain Visual Analog Scale (VAS) - Per Protocol Population

Timeframe	Studies, this research(%)	All Research%
pre-1990	11 (47.83)	18.7374
1990's	1 (4.35)	18.2507
2000's	6 (26.09)	29.6817
2010's	4 (17.39)	24.3611
2020's	1 (4.35)	2.80

Authors	Studies
Jones, P	2
Lamdin, R	2
Dalziel, SR	2
Miles-Chan, JL	1
Frampton, C	1
Gøtzsche, PC	2
Braund, R	1
Abbott, JH	1
Lyrtzis, C	1
Natsis, K	1
Papadopoulos, C	1
Noussios, G	1
Papathanasiou, E	1
Mahler, P	1
Mahler, F	1
Duruz, H	1
Ramazzina, M	1
Liguori, V	1
Mautone, G	1
Michlovitz, S	1
Hun, L	1
Erasala, GN	1
Hengehold, DA	1
Weingand, KW	1
Dalton, JD	1
Schweinle, JE	1
Hewitt, DJ	1
Todd, KH	1
Xiang, J	1
Jordan, DM	1
Rosenthal, NR	1
Kayali, C	1
Agus, H	1
Surer, L	1
Turgut, A	1
Cameron, PF	1
Abbott, CJ	1
Bouchier-Hayes, TA	1
Hunt, HA	1
Jaffé, GV	1
Roylance, PJ	1
Grimshaw, JJ	1
Gilbert, MM	1
Diebschlag, W	1
Nocker, W	1
Bullingham, R	1
Muncie, HL	1
King, DE	1
DeForge, B	1
Brown, FL	1
Bodison, S	1
Dixon, J	1
Davis, W	1
Nowoslawski, J	1
Aghababian, RV	1
Indelicato, PA	1
Duranceau, JA	1
Lacoste, P	1
Bourgouin, J	1
Phillips, R	1
Walker, JM	1
Aleixo, PL	1
Monteiro, PR	1
da Silva, AC	1

Trial	Phase	Enrollment	Study Type	Start Date	Status
A Randomized, Double-Blind, 7-Day Study of the Efficacy and Safety of Rofecoxib Versus Placebo and Diclofenac in Patients With Acute Painful Rotator Cuff Syndrome[NCT00140933]	Phase 3	274 participants	Interventional	2003-04-30	Terminated
Efficacy and Security of Combined Analgesia (Opioid and Anti-inflammatory Agent) to Control Pain in Children Seen in the Emergency Department for a Trauma of a Limb[NCT01189773]	Phase 4	200 participants (Actual)	Interventional	2008-02-29	Completed
An Open Label Randomized Multicenter Comparative Study On Celecoxib Efficacy And Safety Versus Non-Selective NSAID In Acute Pain Due To Ankle Sprain[NCT00446797]	Phase 4	278 participants (Actual)	Interventional	2007-05-31	Completed
Ibuprofen Versus Acetaminophen vs Their Combination in the Relief of Musculoskeletal Pain in the Emergency Setting[NCT01827475]	Phase 2	90 participants (Actual)	Interventional	2010-07-31	Completed
The Efficacy and Safety of Administration of the COX-2 Selective NSAID, Etoricoxib (120mg od. for 7 Days) Compared to Diclofenac (50 mg Tds. for 7 Days) and Placebo as Adjunct Treatment in the First 7 Days of Treatment of Acute Grade II Lateral Ankle Liga[NCT00954785]	Phase 4	0 participants (Actual)	Interventional	2009-11-30	Withdrawn (stopped due to The study was terminated by Merck USA. The company did not supply drugs for the study.)
A Randomized, Double-Blind, Parallel-Group Study Comparing the Safety and Effectiveness of Acetaminophen Extended Release (3900 mg/Day) and Ibuprofen (1200 mg/Day) in the Treatment of Ankle Sprains.[NCT00261560]	Phase 4	260 participants (Actual)	Interventional		Completed
A Comparison of the Efficacy and Safety of Tramadol HCl/Acetaminophen Versus Hydrocodone Bitartrate/Acetaminophen Versus Placebo in Subjects With Acute Musculoskeletal Pain[NCT00236535]	Phase 3	603 participants (Actual)	Interventional	2003-12-31	Completed
[information is prepared from clinicaltrials.gov, extracted Sep-2024]

"Assessment of ankle pain by VAS: 100 mm horizontal line with left end being No Pain & right end being Worst Possible Pain. Participants drew vertical line on horizontal scale to best reflect current pain on full weight bearing of injured ankle. Distance from left end of line to mark. Change: mean score at day 3 minus mean score at baseline" (NCT00446797)
Timeframe: Baseline and day 3

Change From Baseline in Pain Visual Analog Scale (VAS) - Modified Intent to Treat Population

Intervention	scores on a scale (Mean)
Celecoxib	-44.88
nsNSAIDs	-40.76

"Assessment of ankle pain by VAS: 100 mm horizontal line, left end being No Pain & right end being Worst Possible Pain. Participants drew vertical line on horizontal scale to best reflect current pain on full weight bearing of injured ankle. Distance from left end of line to mark. Change: mean score at observation minus mean score at baseline" (NCT00446797)
Timeframe: Baseline and days 2, 3 and 7

Modified Brief Pain Inventory Short Form (m-BPI-sf) - Pain Interference Index

Intervention	scores on a scale (Mean)
	Day 2	Day 3	Day 7
Celecoxib	-29.25	-44.87	-61.17
nsNSAIDs	-25.98	-40.75	-57.89

"m-BPI-sf questionnaire assessed pain severity and pain interference with functional activities during the 24 hour follow-up period.~The pain interference index is the average of pain interference questions 5A to 5G. Scale: 0 = does not interfere to 10 = completely interferes" (NCT00446797)
Timeframe: Days 2, 3 and 7

Modified Brief Pain Inventory Short Form (m-BPI-sf) - Pain Interference Question 5A

Intervention	scores on a scale (Mean)
	Day 2 (N = 134, 133)	Day 3 (N = 135, 131)	Day 7 (N = 133, 125)
Celecoxib	4.07	2.79	1.28
nsNSAIDs	4.01	2.83	1.33

"m-BPI-sf questionnaire assessed pain severity and pain interference with functional activities during the 24 hour follow-up period.~Q5A: Subject response to 'how, during the past 24 hours, pain has interfered with your general activity. Scale: 0 = does not interfere to 10 = completely interferes" (NCT00446797)
Timeframe: Days 2, 3 and 7

Modified Brief Pain Inventory Short Form (m-BPI-sf) - Pain Interference Question 5B

Intervention	scores on a scale (Mean)
	Day 2 (N = 134, 133)	Day 3 (N = 135, 131)	Day 7 (N = 133, 125)
Celecoxib	5.40	3.65	1.78
nsNSAIDs	5.37	4.07	1.90

"m-BPI-sf questionnaire assessed pain severity and pain interference with functional activities during the 24 hour follow-up period.~Q5B: Subject response to 'how, during the past 24 hours, pain has interfered with your mood'. Scale: 0 = does not interfere to 10 = completely interferes" (NCT00446797)
Timeframe: Days 2, 3 and 7

Modified Brief Pain Inventory Short Form (m-BPI-sf) - Pain Interference Question 5C

Intervention	scores on a scale (Mean)
	Day 2 (N = 134, 133)	Day 3 (N = 135, 131)	Day 7 (N = 133, 125)
Celecoxib	3.72	2.43	1.17
nsNSAIDs	3.64	2.38	1.26

"m-BPI-sf questionnaire assessed pain severity and pain interference with functional activities during the 24 hour follow-up period.~Q5C: Subject response to 'how, during the past 24 hours, pain has interfered with your walking ability'. Scale: 0 = does not interfere to 10 = completely interferes" (NCT00446797)
Timeframe: Days 2, 3 and 7

Modified Brief Pain Inventory Short Form (m-BPI-sf) - Pain Interference Question 5D

Intervention	scores on a scale (Mean)
	Day 2 (N = 134, 133)	Day 3 (N = 135, 131)	Day 7 (N = 133, 125)
Celecoxib	5.10	3.58	1.65
nsNSAIDs	5.11	3.69	1.62

"m-BPI-sf questionnaire assessed pain severity and pain interference with functional activities during the 24 hour follow-up period.~Q5D: Subject response to 'how, during the past 24 hours, pain has interfered with your normal work (work outside the home and housework)'. Scale: 0 = does not interfere to 10 = completely interferes" (NCT00446797)
Timeframe: Days 2, 3 and 7

Modified Brief Pain Inventory Short Form (m-BPI-sf) - Pain Interference Question 5E

Intervention	scores on a scale (Mean)
	Day 2 (N = 134, 133)	Day 3 (N = 135, 131)	Day 7 (N = 133, 125)
Celecoxib	5.29	4.04	1.84
nsNSAIDs	5.39	4.04	1.87

"m-BPI-sf questionnaire assessed pain severity and pain interference with functional activities during the 24 hour follow-up period.~Q5E: Subject response to 'how, during the past 24 hours, pain has interfered with your relations with other people'. Scale: 0 = does not interfere to 10 = completely interferes" (NCT00446797)
Timeframe: Days 2, 3 and 7

Modified Brief Pain Inventory Short Form (m-BPI-sf) - Pain Interference Question 5F

Intervention	scores on a scale (Mean)
	Day 2 (N = 134, 133)	Day 3 (N = 135, 131)	Day 7 (N = 133, 125)
Celecoxib	2.70	1.81	0.80
nsNSAIDs	2.67	1.69	0.78

"m-BPI-sf questionnaire assessed pain severity and pain interference with functional activities during the 24 hour follow-up period.~Q5F: Subject response to 'how, during the past 24 hours, pain has interfered with your sleep'. Scale: 0 = does not interfere to 10 = completely interferes" (NCT00446797)
Timeframe: Days 2, 3 and 7

Modified Brief Pain Inventory Short Form (m-BPI-sf) - Pain Interference Question 5G

Intervention	scores on a scale (Mean)
	Day 2 (N = 134, 133)	Day 3 (N = 135, 131)	Day 7 (N = 133, 125)
Celecoxib	2.97	1.90	0.68
nsNSAIDs	2.87	1.86	0.82

"m-BPI-sf questionnaire assessed pain severity and pain interference with functional activities during the 24 hour follow-up period.~Q5G: Subject response to 'how, during the past 24 hours, pain has interfered with your enjoyment of life'. Scale: 0 = does not interfere to 10 = completely interferes" (NCT00446797)
Timeframe: Days 2, 3 and 7

Modified Brief Pain Inventory Short Form (m-BPI-sf) - Pain Severity Index

Intervention	scores on a scale (Mean)
	Day 2 (N = 134, 133)	Day 3 (N = 135, 131)	Day 7 (N = 133, 125)
Celecoxib	3.33	2.13	1.07
nsNSAIDs	2.99	2.06	1.10

"m-BPI-sf questionnaire assessed pain severity and pain interference with functional activities during the 24 hour follow-up period.~Pain severity index is the average of the pain severity questions 1 to 4. Scale: 0 = no pain to 10 = pain as bad as you can imagine" (NCT00446797)
Timeframe: Days 2, 3 and 7

Modified Brief Pain Inventory Short Form (m-BPI-sf) - Pain Severity Question 1

Intervention	scores on a scale (Mean)
	Day 2 (N = 134, 133)	Day 3 (N = 135, 131)	Day 7 (N = 133, 125)
Celecoxib	4.24	2.84	1.37
nsNSAIDs	4.48	3.26	1.68

"m-BPI-sf questionnaire assessed pain severity and pain interference with functional activities during the 24 hour follow-up period.~Q1: Subject response to 'describe your pain at its worst in the last 24 hours'. Scale: 0 = no pain to 10 = pain as bad as you can imagine" (NCT00446797)
Timeframe: Days 1, 3 and 7

Modified Brief Pain Inventory Short Form (m-BPI-sf) - Pain Severity Question 2

Intervention	scores on a scale (Mean)
	Day 2 (N = 134, 133)	Day 3 (N = 135, 131)	Day 7 (N = 133, 125)
Celecoxib	5.71	3.81	2.08
nsNSAIDs	5.90	4.44	2.38

"m-BPI-sf questionnaire assessed pain severity and pain interference with functional activities during the 24 hour follow-up period.~Q2: Subject response to 'describe your pain at its least in the last 24 hours'. Scale: 0 = no pain to 10 = pain as bad as you can imagine" (NCT00446797)
Timeframe: Days 2, 3 and 7

Modified Brief Pain Inventory Short Form (m-BPI-sf) - Pain Severity Question 3

Intervention	scores on a scale (Mean)
	Day 2 (N = 133, 133)	Day 3 (N = 135, 131)	Day 7 (N = 133, 125)
Celecoxib	3.25	2.07	0.83
nsNSAIDs	3.36	2.40	1.16

"m-BPI-sf questionnaire assessed pain severity and pain interference with functional activities during the 24 hour follow-up period.~Q3: Subject response to 'describe your pain on the average'. Scale: 0 = no pain to 10 = pain as bad as you can imagine" (NCT00446797)
Timeframe: Days 2, 3 and 7

Modified Brief Pain Inventory Short Form (m-BPI-sf) - Pain Severity Question 4

Intervention	scores on a scale (Mean)
	Day 2 (N = 134, 133)	Day 3 (N = 135, 131)	Day 7 (N = 133, 125)
Celecoxib	4.34	2.90	1.41
nsNSAIDs	4.41	3.26	1.74

"m-BPI-sf questionnaire assessed pain severity and pain interference with functional activities during the 24 hour follow-up period.~Q4: Subject response to 'how much pain you have right now'. Scale: 0 = no pain to 10 = pain as bad as you can imagine" (NCT00446797)
Timeframe: Days 2, 3 and 7

Number of Subjects Responding (Improving) - MITT Population

Intervention	scores on a scale (Mean)
	Day 2 (N = 134, 133)	Day 3 (N =135, 131)	Day 7 (N = 133, 125)
Celecoxib	3.64	2.58	1.14
nsNSAIDs	4.23	2.92	1.43

The number of subjects showing a response: a decrease of at least 20 mm (that is improvement) on the pain visual analog scale (VAS) scale (NCT00446797)
Timeframe: Days 2, 3 and 7

Pain Relief - MITT Population

Intervention	participants (Number)
	Day 2 - response (N=134, 133)	Day 2 - no response	Day 3 - response (N=135, 131)	Day 3 - no response	Day 7 - response (N=133, 125)	Day 7 - no response
Celecoxib	91	43	124	11	129	4
nsNSAIDs	79	54	116	15	120	5

"Subject's response to the statement My relief from starting pain is. Scale from 0 = None to 4 = Complete." (NCT00446797)
Timeframe: Days 2, 3 and 7

Physician Global Assessment of Ankle Injury

Intervention	participants (Number)
	Day 2 - None (N=135, 132)	Day 2 - A little	Day 2 - Some	Day 2 - A lot	Day 2 -Complete	Day 3 - None (N=135, 131)	Day 3 - A little	Day 3 - Some	Day 3 - A lot	Day 3 -Complete	Day 7 - None (N=133, 125)	Day 7 - A little	Day 7 - Some	Day 7 - A lot	Day 7 -Complete
Celecoxib	8	25	49	52	1	0	15	33	84	3	1	6	7	77	42
nsNSAIDs	5	33	52	42	0	1	21	46	60	3	1	3	15	80	26

Investigator evaluation of overall severity of ankle injury. Scale: 5 point from 1 = Very mild (very mild signs and symptoms of ankle sprain) to 5 =Very severe (very severe signs and symptoms of ankle sprain) (NCT00446797)
Timeframe: Days 3 and 7

Subject Assessment of Normal Function / Activity

Intervention	participants (Number)
	Day 3 - very mild (N=134, 131)	Day 3 - mild	Day 3 - moderate	Day 3 - severe	Day 3 - very severe	Day 7 - very mild (N=132, 125)	Day 7 - mild	Day 7 - moderate	Day 7 - severe	Day 7 - very severe
Celecoxib	20	71	40	2	1	87	38	7	0	0
nsNSAIDs	12	79	38	2	0	70	47	7	1	0

"Subject response to question: How does your ankle injury affect your walking and normal activity? Scale from 1 = Normal walking/activity and no pain to 5 = Severely restricted walking due to pain and can't resume normal activities (normal activities defined as all activity that a subject did on a routine basis, including work and recreation)" (NCT00446797)
Timeframe: Days 2, 3 and 7

Subject's Global Assessment of Ankle Injury

Intervention	participants (Number)
	Day 2 - normal no pain (N =135, 133)	Day 2 - normal with pain	Day 2 - mildly restricted	Day 2 - moderately restricted	Day 2 - severely restricted	Day 3 - normal no pain (N = 135, 131)	Day 3 - normal with pain	Day 3 - mildly restricted	Day 3 - moderately restricted	Day 3 - severely restricted	Day 7 - normal no pain (N = 133, 125)	Day 7 - normal with pain	Day 7 - mildly restricted	Day 7 - moderately restricted	Day 7 - severely restricted
Celecoxib	5	40	59	19	12	18	52	49	14	2	62	55	11	4	1
nsNSAIDs	2	30	55	39	7	13	46	57	11	4	43	68	8	3	3

"Subject response to question: Considering all the ways your ankle injury affects you, how are you doing today? Scale: 5 point from 1 = very good (no symptoms and no limitation of normal activities) to 5 = very poor (very severe symptoms which are intolerable and inability to carry out all normal activities)." (NCT00446797)
Timeframe: Days 2, 3 and 7

Need for Rescue Pain Relief

Pain Severity

Intervention	participants (Number)
	Day 2 - Very good (no symptoms) (N=135, 133)	Day 2 - Good (mild symptoms)	Day 2 - Fair (moderate symptoms)	Day 2 - Poor (severe symptoms)	Day 2- Very poor (very severe symptoms)	Day 3 - Very good (no symptoms) (N=135, 131)	Day 3 - Good (mild symptoms)	Day 3 - Fair (moderate symptoms)	Day 3 - Poor (severe symptoms)	Day 3 - Very poor (very severe symptoms)	Day 7 - Very good (no symptoms) (N=133, 125)	Day 7 - Good (mild symptoms)	Day 7 - Fair (moderate symptoms)	Day 7 - Poor (severe symptoms)	Day 7 - Very poor (very severe symptoms)
Celecoxib	1	40	76	17	1	8	68	54	5	0	53	61	17	2	0
nsNSAIDs	1	31	80	19	2	6	55	63	7	0	37	63	21	4	0

Intervention	participants (Number)
Ibuprofen	11
Acetaminophen	10
Ibuprofen-acetaminophen Combination	5

Pain score on 100 mm VAS from 0 (no pain) to 100 (worst pain) (NCT01827475)
Timeframe: 1 hour

Article	Year
Oral non-steroidal anti-inflammatory drugs versus other oral analgesic agents for acute soft tissue injury. The Cochrane database of systematic reviews, 2020, 08-12, Volume: 8 Topics: Acetaminophen; Acute Disease; Administration, Oral; Adult; Analgesics; Analgesics, Opioid; Anti-Infl	2020
Oral non-steroidal anti-inflammatory drugs versus other oral analgesic agents for acute soft tissue injury. The Cochrane database of systematic reviews, 2020, 08-12, Volume: 8 Topics: Acetaminophen; Acute Disease; Administration, Oral; Adult; Analgesics; Analgesics, Opioid; Anti-Infl	2020
Oral non-steroidal anti-inflammatory drugs versus other oral analgesic agents for acute soft tissue injury. The Cochrane database of systematic reviews, 2020, 08-12, Volume: 8 Topics: Acetaminophen; Acute Disease; Administration, Oral; Adult; Analgesics; Analgesics, Opioid; Anti-Infl	2020
Oral non-steroidal anti-inflammatory drugs versus other oral analgesic agents for acute soft tissue injury. The Cochrane database of systematic reviews, 2020, 08-12, Volume: 8 Topics: Acetaminophen; Acute Disease; Administration, Oral; Adult; Analgesics; Analgesics, Opioid; Anti-Infl	2020
Oral non-steroidal anti-inflammatory drugs versus other oral analgesic agents for acute soft tissue injury. The Cochrane database of systematic reviews, 2020, 08-12, Volume: 8 Topics: Acetaminophen; Acute Disease; Administration, Oral; Adult; Analgesics; Analgesics, Opioid; Anti-Infl	2020
Oral non-steroidal anti-inflammatory drugs versus other oral analgesic agents for acute soft tissue injury. The Cochrane database of systematic reviews, 2020, 08-12, Volume: 8 Topics: Acetaminophen; Acute Disease; Administration, Oral; Adult; Analgesics; Analgesics, Opioid; Anti-Infl	2020
Oral non-steroidal anti-inflammatory drugs versus other oral analgesic agents for acute soft tissue injury. The Cochrane database of systematic reviews, 2020, 08-12, Volume: 8 Topics: Acetaminophen; Acute Disease; Administration, Oral; Adult; Analgesics; Analgesics, Opioid; Anti-Infl	2020
Oral non-steroidal anti-inflammatory drugs versus other oral analgesic agents for acute soft tissue injury. The Cochrane database of systematic reviews, 2020, 08-12, Volume: 8 Topics: Acetaminophen; Acute Disease; Administration, Oral; Adult; Analgesics; Analgesics, Opioid; Anti-Infl	2020
Oral non-steroidal anti-inflammatory drugs versus other oral analgesic agents for acute soft tissue injury. The Cochrane database of systematic reviews, 2020, 08-12, Volume: 8 Topics: Acetaminophen; Acute Disease; Administration, Oral; Adult; Analgesics; Analgesics, Opioid; Anti-Infl	2020
Oral non-steroidal anti-inflammatory drugs versus other oral analgesic agents for acute soft tissue injury. The Cochrane database of systematic reviews, 2020, 08-12, Volume: 8 Topics: Acetaminophen; Acute Disease; Administration, Oral; Adult; Analgesics; Analgesics, Opioid; Anti-Infl	2020
Oral non-steroidal anti-inflammatory drugs versus other oral analgesic agents for acute soft tissue injury. The Cochrane database of systematic reviews, 2020, 08-12, Volume: 8 Topics: Acetaminophen; Acute Disease; Administration, Oral; Adult; Analgesics; Analgesics, Opioid; Anti-Infl	2020
Oral non-steroidal anti-inflammatory drugs versus other oral analgesic agents for acute soft tissue injury. The Cochrane database of systematic reviews, 2020, 08-12, Volume: 8 Topics: Acetaminophen; Acute Disease; Administration, Oral; Adult; Analgesics; Analgesics, Opioid; Anti-Infl	2020
Oral non-steroidal anti-inflammatory drugs versus other oral analgesic agents for acute soft tissue injury. The Cochrane database of systematic reviews, 2020, 08-12, Volume: 8 Topics: Acetaminophen; Acute Disease; Administration, Oral; Adult; Analgesics; Analgesics, Opioid; Anti-Infl	2020
Oral non-steroidal anti-inflammatory drugs versus other oral analgesic agents for acute soft tissue injury. The Cochrane database of systematic reviews, 2020, 08-12, Volume: 8 Topics: Acetaminophen; Acute Disease; Administration, Oral; Adult; Analgesics; Analgesics, Opioid; Anti-Infl	2020
Oral non-steroidal anti-inflammatory drugs versus other oral analgesic agents for acute soft tissue injury. The Cochrane database of systematic reviews, 2020, 08-12, Volume: 8 Topics: Acetaminophen; Acute Disease; Administration, Oral; Adult; Analgesics; Analgesics, Opioid; Anti-Infl	2020
Oral non-steroidal anti-inflammatory drugs versus other oral analgesic agents for acute soft tissue injury. The Cochrane database of systematic reviews, 2020, 08-12, Volume: 8 Topics: Acetaminophen; Acute Disease; Administration, Oral; Adult; Analgesics; Analgesics, Opioid; Anti-Infl	2020
Oral non-steroidal anti-inflammatory drugs versus other oral analgesic agents for acute soft tissue injury. The Cochrane database of systematic reviews, 2020, 08-12, Volume: 8 Topics: Acetaminophen; Acute Disease; Administration, Oral; Adult; Analgesics; Analgesics, Opioid; Anti-Infl	2020
Oral non-steroidal anti-inflammatory drugs versus other oral analgesic agents for acute soft tissue injury. The Cochrane database of systematic reviews, 2020, 08-12, Volume: 8 Topics: Acetaminophen; Acute Disease; Administration, Oral; Adult; Analgesics; Analgesics, Opioid; Anti-Infl	2020
Oral non-steroidal anti-inflammatory drugs versus other oral analgesic agents for acute soft tissue injury. The Cochrane database of systematic reviews, 2020, 08-12, Volume: 8 Topics: Acetaminophen; Acute Disease; Administration, Oral; Adult; Analgesics; Analgesics, Opioid; Anti-Infl	2020
Oral non-steroidal anti-inflammatory drugs versus other oral analgesic agents for acute soft tissue injury. The Cochrane database of systematic reviews, 2020, 08-12, Volume: 8 Topics: Acetaminophen; Acute Disease; Administration, Oral; Adult; Analgesics; Analgesics, Opioid; Anti-Infl	2020
Oral non-steroidal anti-inflammatory drugs versus other oral analgesic agents for acute soft tissue injury. The Cochrane database of systematic reviews, 2020, 08-12, Volume: 8 Topics: Acetaminophen; Acute Disease; Administration, Oral; Adult; Analgesics; Analgesics, Opioid; Anti-Infl	2020
Oral non-steroidal anti-inflammatory drugs versus other oral analgesic agents for acute soft tissue injury. The Cochrane database of systematic reviews, 2020, 08-12, Volume: 8 Topics: Acetaminophen; Acute Disease; Administration, Oral; Adult; Analgesics; Analgesics, Opioid; Anti-Infl	2020
Oral non-steroidal anti-inflammatory drugs versus other oral analgesic agents for acute soft tissue injury. The Cochrane database of systematic reviews, 2020, 08-12, Volume: 8 Topics: Acetaminophen; Acute Disease; Administration, Oral; Adult; Analgesics; Analgesics, Opioid; Anti-Infl	2020
Oral non-steroidal anti-inflammatory drugs versus other oral analgesic agents for acute soft tissue injury. The Cochrane database of systematic reviews, 2020, 08-12, Volume: 8 Topics: Acetaminophen; Acute Disease; Administration, Oral; Adult; Analgesics; Analgesics, Opioid; Anti-Infl	2020
Oral non-steroidal anti-inflammatory drugs versus other oral analgesic agents for acute soft tissue injury. The Cochrane database of systematic reviews, 2020, 08-12, Volume: 8 Topics: Acetaminophen; Acute Disease; Administration, Oral; Adult; Analgesics; Analgesics, Opioid; Anti-Infl	2020
Oral non-steroidal anti-inflammatory drugs versus other oral analgesic agents for acute soft tissue injury. The Cochrane database of systematic reviews, 2015, Jul-01, Issue:7 Topics: Acetaminophen; Acute Disease; Administration, Oral; Analgesics; Analgesics, Opioid; Anti-Inflammator	2015
NSAIDs. BMJ clinical evidence, 2007, Jun-01, Volume: 2007 Topics: Acetaminophen; Acute Disease; Adrenal Cortex Hormones; Anti-Inflammatory Agents, Non-Steroidal; Dose	2007
NSAIDs. BMJ clinical evidence, 2010, Jun-28, Volume: 2010 Topics: Acetaminophen; Acute Disease; Adrenal Cortex Hormones; Anti-Inflammatory Agents, Non-Steroidal; Huma	2010

Article	Year
Efficacy of paracetamol versus diclofenac for Grade II ankle sprains. Foot & ankle international, 2011, Volume: 32, Issue:6 Topics: Acetaminophen; Adolescent; Adult; Analgesics, Non-Narcotic; Ankle Injuries; Anti-Inflammatory Agents	2011
Double-blind, randomized, controlled study on the efficacy and safety of a novel diclofenac epolamine gel formulated with lecithin for the treatment of sprains, strains and contusions. Drugs under experimental and clinical research, 2003, Volume: 29, Issue:1 Topics: Acetaminophen; Administration, Topical; Adolescent; Adult; Aged; Analgesics, Non-Narcotic; Ankle Inj	2003
Continuous low-level heat wrap therapy is effective for treating wrist pain. Archives of physical medicine and rehabilitation, 2004, Volume: 85, Issue:9 Topics: Acetaminophen; Activities of Daily Living; Adolescent; Adult; Aged; Analgesics, Non-Narcotic; Bandag	2004
Randomized controlled noninferiority trial to compare extended release acetaminophen and ibuprofen for the treatment of ankle sprains. Annals of emergency medicine, 2006, Volume: 48, Issue:5 Topics: Acetaminophen; Analgesics, Non-Narcotic; Ankle Injuries; Arthralgia; Contusions; Double-Blind Method	2006
Tramadol/acetaminophen or hydrocodone/acetaminophen for the treatment of ankle sprain: a randomized, placebo-controlled trial. Annals of emergency medicine, 2007, Volume: 49, Issue:4 Topics: Acetaminophen; Adult; Analgesics, Opioid; Ankle Injuries; Drug Combinations; Humans; Hydrocodone; Ma	2007
The efficacy of paracetamol in the treatment of ankle sprains in comparison with diclofenac sodium. Saudi medical journal, 2007, Volume: 28, Issue:12 Topics: Acetaminophen; Adult; Analgesics, Non-Narcotic; Ankle Injuries; Anti-Inflammatory Agents, Non-Steroi	2007
A comparison of the efficacy of naproxen sodium and a paracetamol/dextropropoxyphene combination in the treatment of soft-tissue disorders. British journal of sports medicine, 1980, Volume: 14, Issue:4 Topics: Acetaminophen; Adult; Athletic Injuries; Clinical Trials as Topic; Contusions; Dextropropoxyphene; D	1980
A controlled study of diflunisal in sprains and strains. Current medical research and opinion, 1978, Volume: 5, Issue:7 Topics: Acetaminophen; Adolescent; Adult; Age Factors; Aged; Analgesics; Biphenyl Compounds; Dextropropoxyph	1978
The efficacy of Percogesic in relief of musculoskeletal pain associated with anxiety. Psychosomatics, 1976, Volume: 17, Issue:4 Topics: Acetaminophen; Adolescent; Adult; Aged; Anxiety; Clinical Trials as Topic; Drug Combinations; Female	1976
A double-blind study of the efficacy of topical ketorolac tromethamine gel in the treatment of ankle sprain, in comparison to placebo and etofenamate. Journal of clinical pharmacology, 1990, Volume: 30, Issue:1 Topics: Acetaminophen; Administration, Topical; Adult; Ankle; Ankle Injuries; Anti-Inflammatory Agents, Non-	1990
Treatment of mild to moderate pain of acute soft tissue injury: diflunisal vs acetaminophen with codeine. The Journal of family practice, 1986, Volume: 23, Issue:2 Topics: Acetaminophen; Acute Disease; Adult; Back Pain; Clinical Trials as Topic; Codeine; Diflunisal; Drug	1986
Comparison of diflunisal and acetaminophen with codeine in the treatment of initial or recurrent acute low back strain. Clinical therapeutics, 1986, Volume: 9 Suppl C Topics: Acetaminophen; Adult; Back Pain; Clinical Trials as Topic; Codeine; Diflunisal; Drug Combinations; D	1986
Comparison of diflunisal and acetaminophen with codeine in the management of grade 2 ankle sprain. Clinical therapeutics, 1986, Volume: 8, Issue:5 Topics: Acetaminophen; Adult; Ankle Injuries; Codeine; Diflunisal; Drug Combinations; Edema; Female; Humans;	1986
Comparison of diflunisal and acetaminophen with codeine in the treatment of mild to moderate pain due to strains and sprains. Clinical therapeutics, 1986, Volume: 8, Issue:3 Topics: Acetaminophen; Adolescent; Adult; Athletic Injuries; Clinical Trials as Topic; Codeine; Diflunisal;	1986
Double-blind comparison of ketoprofen and placebo in the treatment of sprains and strains. Clinical therapeutics, 1986, Volume: 8, Issue:2 Topics: Acetaminophen; Adolescent; Adult; Cryotherapy; Double-Blind Method; Female; Humans; Immobilization;	1986
Value of an acetaminophen-chlorzoxazone combination (parafon forte) in the treatment of acute musculoskeletal disorders. Current therapeutic research, clinical and experimental, 1973, Volume: 15, Issue:5 Topics: Acetaminophen; Benzoxazoles; Chlorzoxazone; Clinical Trials as Topic; Drug Combinations; Humans; Lum	1973

Article	Year
Recommending NSAIDs and paracetamol: A survey of New Zealand physiotherapists' knowledge and behaviours. Physiotherapy research international : the journal for researchers and clinicians in physical therapy, 2011, Volume: 16, Issue:1 Topics: Acetaminophen; Adult; Aged; Anti-Inflammatory Agents, Non-Steroidal; Health Knowledge, Attitudes, Pr	2011
Strained abdominal muscles as a cause of acute abdominal pain in children and young adults and its treatment with Paramax. The British journal of clinical practice, 1983, Volume: 37, Issue:5 Topics: Abdomen; Abdominal Muscles; Acetaminophen; Adolescent; Adult; Child; Drug Combinations; Female; Huma	1983
[Clinical observations and analgesic properties of the association of paracetamol and phenylbutazone]. Revista brasileira de medicina, 1966, Volume: 23, Issue:9 Topics: Acetaminophen; Back Pain; Contusions; Ear Diseases; Headache; Humans; Joint Diseases; Muscular Disea	1966

acetaminophen and Sprains and Strains