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Paracetamol or acetaminophen known as Tylenol in the US, is the most commonly prescribed drug in case of low back pain. This kind of pain is a common reason to why people miss work time, therefore it is important to find a way to treat it. However taking paracetamol has no effect, according to a large international study.
The existing recommendations on pain relief were challenged by the results of 13 studies. The team of researchers led by Gustavo Machado of The George Institute for Global Health at the University of Sydney in Australia reached the conclusion that paracetamol offers little relief for common forms of arthritis and back pain.
Most clinical guidelines recommend paracetamol as the first choice when it comes to osteoarthritis of the hip and knee or low back pain. However a systematic review of the evidence for this has never been made.
Machado and his team investigated three clinical trials and reached the conclusion that paracetamol is no better than placebo at treating low back pain. A further analysis of 10 other clinical trials showed for the first time what is the actual effect that paracetamo has on reducing pain. Machado declared that the effect was too insignificant to be clinically worthwile.
Just because paracetamol can be used in treating headaches this does not mean it can work in every circumstances. Machado explained that the pain mechanism in headaches is different compared to osteoarthritis and low back pain. The effects of this medicine are not properly understood.
The maker of Tylenol, McNeil Consumer Healthcare, said that the medicine is effective and its effectiveness is supported by over 150 studies conducted in the past 50 years.
Dr. Houman Danesh, an expert of Mount Sinai School of Medicine in New York City, said that back pain can have different factors. Patients may have musculoskeletal imbalances, arthritis, improper shoe support or pain caused by herniated disk. When treating a patient it is not recommended to combine all these diagnoses under the all-inclusive label of “back pain”.
Danesh said that pills are not always a solution. Weight loss, acupuncture, physical exercises and proper ergonomics at the work place may have the same role which paracetamol has in treating back pain. Expert in physical rehabilitation, Dr. Allyson Shrikande also supports this idea. She said that individually tailored programs for physical therapy should be tried before using any medication.
Another problem that arises is the one of safety. Elaine Hay and Christian Mallen of Keele University in England wrote in a journal editorial that if paracetamol were to be removed from the current treatment guidelines this may lead to the increased usage of more powerful and even addictive narcotic painkillers.
Image Source: ScienceNordic
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