Three issues related to the management of acute musculoskeletal pain in the ambulatory care setting deserve more attention than they currently receive: pain assessment, the degree of diagnostic specificity needed to select treatment, and gaps in the care that clinicians need to consider. This article describes several pain assessment instruments and explains why they are appropriate in the acute care setting. It also reviews several reports demonstrating that most patients with acute musculoskeletal pain, particularly low back pain, cannot be given a definitive pathoanatomical diagnosis. Therefore, categorizing the pain as mechanical or secondary to underlying causes is sufficient to select and institute treatment. Gaps in care, such as the need for increased patient education, accurate information to dispel misconceptions about therapy, and additional safety and efficacy data about drugs used to treat acute musculoskeletal pain, are also addressed.