This article explores the evidence on the use of non-steroidal anti-inflammatory (NSAID) medications in the management of acute soft tissue injuries such as sprains. NSAIDs have been used for these injuries, on the basis that they reduce pain and lead to a stronger and more effective return to function. However, there is little evidence in support of the latter, and a growing body of evidence is suggesting NSAIDs can delay healing due to their effect on inflammation. The potential side-effects of NSAIDs are another cause for concern. Paracetamol has been proven to be an effective and safe analgesic that does not interfere with the healing process, and should be the first choice of analgesia.