Acetaminophen Fails in Back Pain Trial
Written by Editor   
Tuesday, August 05, 2014 11:21 AM

About two-thirds of adults have lower back pain at some point in their lives.  Most are told to take acetaminophen, and Medical guidelines around the world recommend acetaminophen as a first-line treatment. But there has never been much research to support the recommendation, and now a large, rigorous trial has found that acetaminophen is not effective for lower back pain.

The use of acetaminophen for acute low-back pain was no more effective than placebo with similar times to recovery regardless of whether the drug was taken regularly or as needed, a large randomized trial found.

"Guidelines for acute low-back pain universally recommend paracetamol [acetaminophen in the U.S.] as the first-line analgesic," authors observed, but noted that there is little evidence to support this recommendation.

Among patients who took acetaminophen on a regular schedule, median time to recovery was 17 days compared with 16 days for patients receiving placebo.  And patients who took the drug as needed also had a median time to recovery of 17 days.  

"Our results convey the need to reconsider the universal endorsement of paracetamol in clinical practice guidelines as first-line care for low-back pain," they observed.

"This study adds to what we've known for a while: everything works for low-back pain -- ice, heat, exercises, ibuprofen, Tylenol -- but nothing works that well," said one MD.  "I usually use episodes of low-back pain as a chance to counsel patients about weight loss and exercise, both of which usually decrease the frequency of episodes of low-back pain."   Chiropractic care which seeks to reduce mechanical stresses and improve mobility and function is another prime option in low back pain.

"Although the findings from this high-quality trial are clear, the content of guidelines should not be changed on the basis of a single trial; more robust and consistent evidence, including verification of the results in other populations, is needed."