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The aim of this systematic review and meta‐analysis was to determine if a combination of analgesics conveys any significant clinical benefit over paracetamol alone in managing acute musculoskeletal injuries. Six studies were identified (n = 1254) and overall there was no clinically important difference between groups for reduction in pain score in the first 2 h, 24 h or 72 h. In conclusion, paracetamol monotherapy is a reasonable first‐line analgesic for acute musculoskeletal injuries as combining additional oral agents does not result in any significant additional analgesic effect.