Pain is the most common complaint bringing patients to the emergency department(ED), with a prevalence ranging from 45% to 75%¹. Despite being such common complain, under diagnosis and under treatment are not very uncommon, and oligoanalgesia is very rampant in EDs². However, at many centers liberal use of opioids in acute pain and chronic cancer pain has led to abuse, increased morbidity and mortality³. Although Joint Commission on Accreditation of Healthcare Organizations has revised pain management standards, these regulatory changes are yet to affect ED pain management practice. Nowadays after understanding the neurobiological aspect of pain, its specific mechanism and neurophysiology we tend to use precise type and amount of analgesic or an intervention closest to the pain generating focus, which allows cutting down on opioid consumption with overall better pain scores in ED.