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Paracetamol Not Effective For Low Back Pain, Study Shows

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Most people suffer from back pain at some point in their life, and many turn to over-the-counter remedies. But new research suggests that paracetamol is no more effective than placebo in relieving lower back pain.

The study, published in the British Medical Journal this week, examined the efficacy and safety of paracetamol in the management of spinal pain (neck or low back pain) and osteoarthritis of the hip or knee.

Researchers conducted randomised controlled trials to compare paracetamol with placebo. They found evidence to show that paracetamol is ineffective for reducing pain intensity and disability or for improving quality of life in the short term in people with low back pain.

For hip or knee osteoarthritis patients, the study showed that paracetamol has a significant, but not clinically important, effect on pain and disability in the short term.

The number of patients reporting adverse events were similar in the paracetamol and placebo groups, although patients taking paracetamol were nearly four times more likely to have abnormal results on liver function tests.

Current UK guidelines recommend paracetamol as the first line drug treatment for both spinal pain and osteoarthritis, but this research raises questions about that approach.

An editorial in the BMJ noted that if paracetamol is taken off the existing guidelines it might lead to an increase in the use of other prescribed drugs, such as opioids – bringing new associated health problems.

Instead, the authors called for the use of alternative treatments that are known to be safe and effective, especially non-drug options, such as exercise, manual therapy, acupuncture and psychological support. And they pointed out that topical NSAIDs (such as ibuprofen) are just as effective as oral NSAIDs for knee osteoarthritis, and are associated with fewer side effects.