Acetaminophen Probably Won’t Help Your Back Pain, New Study Says

by LMatthews on July 24, 2014

acetaminophen no help for acute low back pain reliefAlmost everyone suffers from back pain at some point in their life and for many of us this means popping a painkiller or two and just getting on with things. After all, this is the general advice given by physicians, with acetaminophen the first choice for pain relief. However, there is no real evidence base for this recommendation; acetaminophen is simply preferred over non-steroidal anti-inflammatory drugs because it has a slightly better safety profile.

Now, though, the first randomized placebo-controlled trial of paracetamol (acetaminophen) has revealed that compared to placebo the drug has no effect on pain, speed of recovery or other factors related to acute low back pain. So why are we still reaching for that bottle of Tylenol when back pain strikes?


Lead author of the new study, Christopher Williams, PhD, of the George Institute for Global Health at the University of Sydney in Australia, noted that acetaminophen had no effect on pain, disability, function, global symptoms change, sleep quality or quality of life for those with acute low back pain. Instead, what the researchers found was that good quality advice and reassurance appeared to help patients recover more quickly.

In this particular study some 1652 patients with acute low back pain were randomly assigned to receive either acetaminophen equivalent to 3990mg per day split into three doses (550 patients), placebo (553 patients), or up to 4000mg acetaminophen on an as-needed basis (546 patients). The participants were deemed to have recovered from their acute low back pain when they had a pain score of 0 or 1 out of 10 for seven days straight.


Average Recovery No Different with Acetaminophen

What Williams and colleagues found was that those taking the acetaminophen took an average (median) of 17 days to recover while those receiving placebo took just 16 days. As the rate of adverse effects reported was similar across the groups (at around 18.5%) this brings into question the merits of using acetaminophen as a first line of treatment for acute low back pain.

Are NSAIDs Better for Back Pain?

Those thinking that this study suggests it’s better to take non-steroidal anti-inflammatory drugs (NSAIDs) instead of acetaminophen would be wise to note that earlier research has found no difference between these when used for managing acute low back pain. So, instead of popping paracetamol (Tylenol) for sudden pain in the lower back it may be best to simply talk to your physician or a dedicated pain specialist and get some good advice and reassurance about spinal health.

Alternative methods of pain relief may include massage, postural retraining, acupressure or acupuncture, floatation therapy or magnesium salts, rest, physical therapy, and even mindfulness training and meditation for low back pain.

Reference

Williams, C.M., et al., (2014). Efficacy of paracetamol for acute low-back pain: a double-blind, randomised controlled trial. The Lancet, Early Online Publication, 24 July 2014.

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