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Systematic review
No difference in pain, swelling or function with NSAIDs compared with paracetamol for soft tissue injury
  1. Michel P J van den Bekerom
  1. Department of Orthopaedic and Trauma Surgery, OLVG, Amsterdam, The Netherlands
  1. Correspondence to: Dr Michel P J van den Bekerom, Department of Orthopaedic and Trauma Surgery, OLVG, Oosterpark 9, Amsterdam 1090HM, The Netherlands; bekerom{at}

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Implications for practice and research

  • Paracetamol may be the first choice of treatment for soft tissue injuries because of less adverse events and similar efficacy as non-steroidal anti-inflammatory drugs (NSAIDs).

  • Additional randomised controlled trials (RCTs) are required to determine if there is a difference in return to function or adverse effects between non-selective and COX-2 selective NSAIDs versus paracetamol.

  • Future research should also focus on very old and very young people.


Acute soft tissue injuries are common especially in sport activities. These injuries are responsible for a high number of emergency department attendances and high socioeconomic costs. Acute soft tissue injuries include a number of conditions such as sprain, strain, …

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  • Competing interests None declared.