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The purpose of this systematic review was to compare corticosteroid injections with non-steroidal anti-inflammatory drug (NSAID) injections for musculoskeletal pain. Fourteen studies were identified. We found that in non-musculoskeletal chronic pain the overall benefit of NSAID/steroidal injections was similar; no statistically significant difference was found for pain reduction after each kind of intervention. The authors concluded that NSAIDs are not effective as adjunctive treatments for musculoskeletal pain, but that corticosteroids can be used as a non-additive alternative. Introduction Sixty-five million Americans suffer from chronic, non-cancer pain . The burden imposed by chronic pain on both the individual health care provider and the government is substantial. Rates of non-cancer physical illness (i.e., pain, musculoskeletal pain, etc.) increased nearly 20-fold since 1960 . While the rate of disability from such conditions has decreased over time, disability is still a significant financial burden because people with chronic pain must constantly balance medical treatment with daily activities . Pain, pain intensity, and pain-related physical or mental symptoms are a key component of the chronic pain phenotype, which encompasses physical disability and social impairment, in addition to functional, psychological, and cognitive impairment . Most people with chronic pain do not have a diagnosis of cancer since the diagnosis is usually based on self-reported pain. Pain intensity is a common symptom. There are currently no reliable, individual-based measures of pain intensity that are reliable and objective. A Cochrane review examined the efficacy of NSAID use for treatment of musculoskeletal pain as reported by medical records. Fourteen studies met the inclusion criteria and provided the outcome, effect estimate, and relative risk (RR) over a 6-month follow-up . In these studies, no statistically significant differences were found between non-drug and drug groups regarding pain intensity (RR = 0.99; 95% CI, 0.84 - 1.29; P = 0.29). However, there were significant differences in pain intensity by type and grade of pain: NSAID/steroidal (RR = 1.04; 95% CI, 0.86 - 1.31; P < 0.0001), steroid (RR = 2.23; 95% CI, 1.01 - 4.60; P < 0.0001), and NSAIDs combined (RR = 1.31; 95% CI, 0.93 - 3.92; P < 0.0001) (Figure 1). Overall, the effect estimate of Related Article: