New Findings Challenge Common Drug Treatment for Back Pain

Paracetamol, also known as acetaminophen in the United States, is no more effective than a placebo in treating back pain and arthritis, a study by Australian researchers has found.

A team from the University of Sydney performed a meta-analysis of 13 clinical trials with more than 5,000 combined participants and found no evidence that taking the over-the-counter drug — routinely recommended for managing back pain — reduced pain levels, allowed for better sleep, shortened recovery time, improved quality of life, or reduced disability. When recommended for hip or knee osteoarthritis, the improvement was so small as to be “not clinically important.”

Moreover, the researchers warned, regular use of the drug increased the chance of liver damage.

“These results support the reconsideration of recommendations to use paracetamol for patients with low back pain and osteoarthritis of the hip or knee in clinical practice guidelines,” the authors concluded in the report.

Back pain is extremely common, affecting about 80% of the population at some time, and low back pain is actually the leading cause of disability worldwide. Back pain is also the leading cause of disability for Americans younger than 45.

The team, led by Gustavo Machado, say that interventions other than drugs should be considered as a first-line response to these problems. Exercise, for example, has been shown to be highly effective in helping patients manage and decrease pain in the back and arthritic joints.

“Taking ANY drug to cover up back pain doesn’t make sense,” says Dr. Erwin Gemmer, Life Force Chiropractic. “Pain is a warning signal of an underlying problem. When the warning sign is covered up, a person may engage in activities that will damage the discs or nerves of the back without feeling the warning to stop. Picture someone whose hand is being burned by a hot frying pan and taking pain deadening drugs instead of taking the hand off the hot pan. Not a very good idea!”

Paracetamol is often taken for head and body aches, and is probably best known in the U.S. by the brand name Tylenol. It interferes with pain transmission by blocking enzymes in the brain and spinal cord, and is both sold as a stand-alone pill and included in liquid and capsule versions of common cold and flu medicines.

The full study has been published in the British Medical Journal and is available online.

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