Oh, brace yourselves for a groundbreaking revelation: service members experience more pain than civilians. Who would’ve thought that a lifestyle of dodging bullets and lugging around 80-pound rucksacks could lead to a bit of an “ouchie”? But fear not, for this narrative review is here to save the day with a revolutionary stepwise approach to pain management that—hold your applause—suggests trying nonopioid treatments before diving into the opioid candy jar.

And because we’re all about that evidence-based life, we’ve scoured the depths of PubMed, Google Scholar, WorldCAT, and the Cochrane Library, with the precision of a military operation, to bring you the most relevant articles from the past decade. But don’t get too excited—we’ve excluded anything that doesn’t fit our very specific criteria, because who needs comprehensive data when you can have a neatly curated selection?

Now, let’s talk about the real MVPs of this review: the guidelines. Borrowed from the high and mighty Military Health Care system and the Department of Defense/Veterans Health Administration, these guidelines are like the North Star for navigating the treacherous waters of pain management. But remember, they’re not here to replace the good old-fashioned clinical judgment. No, they’re just a gentle nudge in the right direction, because at the end of the day, it’s all about personalizing that pain relief cocktail to the patient’s liking.

So, what have we learned? Well, if you understand the mechanisms of action and pathways, you might just pinpoint the elusive source of pain. And with that Sherlock Holmes-level deduction, you can tailor a treatment plan that minimizes side effects and maximizes the chances of your patient not hating you for under-treating their pain. But let’s not forget, this guideline is more of a suggestion than a prescription. After all, we wouldn’t want to rob our dear clinicians of the joy of making those tough calls on the battlefield of medicine.