Download this guideline as a pdf, or offline using the QuickChart EMR app for Android

Case definitions

General pain: General musculoskeletal pain
Nonspecific back pain: Nonprogressive back or neck pain
Nonspecific headache: Nonprogressive headache
Osteoarthritis: Chronic (>1 month) pain in one or multiple joints

Consider hospital referral for the following symptoms:

General pain: Obvious distress or functional disability
Nonspecific back pain: Cauda equina symptoms or difficulty ambulating
Nonspecific headache: Abnormal neurologic exam
Osteoarthritis: Signs of rheumatoid arthritis on physical exam or predominant morning stiffness

Clinical management

General pain and osteoarthritis: ACE wraps (for knee supports), stretching activities and analgesic creams, consider physio referral
Nonspecific back pain: Massage neck daily, improve postural mechanics, roll towel and put in the small of the back when sitting
Nonspecific headache: consider dental caries, vision problem

Pharmacologic management

Tylenol 650mg po q4h prn

Adapted from: