Ibuprofen and opioids are similarly effective for short-term relief of acute extremity pain when combined with acetaminophen, according to a JAMA study.
Some 400 adults presenting to the emergency department with moderate-to-severe acute extremity pain (e.g., from sprain or fracture) were randomized to one of four single-dose oral treatments:
Ibuprofen (400 mg) and acetaminophen (1000 mg)
Oxycodone (5 mg) and acetaminophen (325 mg)
Hydrocodone (5 mg) and acetaminophen (300 mg)
Codeine (30 mg) and acetaminophen (300 mg)
At 2 hours, pain scores had declined in all groups, with no statistically or clinically significant differences across the groups.
Dr. Daniel Pallin of NEJM Journal Watch Emergency Medicine offers his take on the findings at the link below.