Musculoskeletal sprains and strains
Clinical basis & sources
- Primary source
- OCP Minor Ailments Prescribing
Sources used
- Ontario Regulation 256/24: GeneralGovernment of Ontario · 2026
- Minor Ailments: Drug Classes and Specified DrugsOntario College of Pharmacists · 2026
- Executive Officer Notice: Update to Funding for Minor Ailment Services in Ontario Pharmacies (Effective July 1, 2026)Government of Ontario · 2026-05-19
- Management of Acute Pain from Non-Low Back Musculoskeletal Injuries: Guidelines from AAFP and ACPAmerican Family Physician · 2020-12-01
- Update on Acute Ankle SprainsAmerican Family Physician · 2012-06-15
- Sprains, Strains and Other Soft-Tissue InjuriesAmerican Academy of Orthopaedic Surgeons OrthoInfo · 2026
Content last reviewed . Spot something outdated? Use the correction link at the bottom of the page.
Allowable drugs under Schedule 4 (9)
Drugs an Ontario pharmacist may prescribe for Musculoskeletal sprains and strains under O. Reg. 256/24, Schedule 4. Choice still depends on the assessment, contraindications, allergies, and product availability — this is the eligible list, not a recommendation.
- Acetaminophen
- Acetylsalicylic acid (ASA)
- Celecoxib
- Diclofenac
- Flurbiprofen
- Ibuprofen
- Ketoprofen
- Mefenamic acid
- Naproxen
Symptoms this assessment screens
- Recent twist, fall without major trauma, overuse, or direct soft-tissue injury
- Localized pain, swelling, bruising, stiffness, spasm, or reduced comfortable movement
- Patient can use the limb or bear weight enough to complete basic activities
- No deformity, open wound, suspected fracture/dislocation, or tendon rupture signs
- No numbness, weakness, cold/blue/pale limb, or vascular compromise symptoms
- Analgesic and NSAID safety screen completed
Red flags — any positive means refer
- Deformity, suspected fracture/dislocation, open wound, severe pain, or inability to bear weight/use the limb
- Ankle/foot injury with inability to bear weight for four steps, malleolar-zone tenderness, navicular tenderness, or fifth-metatarsal base tenderness
- Numbness, tingling, weakness, cold/blue/pale limb, absent pulse, rapidly increasing swelling, or pain out of proportion
- High-energy fall, motor vehicle collision, head/neck/back/chest/abdominal injury, snuffbox tenderness, suspected Achilles rupture, knee instability, or shoulder dislocation concern
- Fever, spreading redness/warmth, pus, infected wound, calf swelling, unilateral leg swelling, shortness of breath, or clot concern
- Anticoagulation/high bleeding risk, significant kidney disease, active peptic ulcer or GI bleed, heart failure, uncontrolled hypertension, pregnancy, frailty, pediatric growth-plate concern, or unsafe analgesic profile
- Symptoms worsen, function declines, or there is no meaningful improvement after 48 to 72 hours of self-care
Sign in to run this assessment
The interactive consult — guided screening, one-click treatment fills, printable assessment, prescription, and physician-notice documents — is free with a ScopeUp account. Enter your email, type the one-time code we send, and every assessment unlocks.