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Paracetamol for back pain? It’s no better than a placebo: Experts say treatment does nothing to improve recovery time, sleep or quality of life

Jenny Hope
paracetamol
  • New study found paracetamol has no effect on lower back pain in sufferers
  • Experts studied 13 research trials – found drug did not improve pain levels
  • Found paracetamol was no more effective than a placebo or dummy pill
  • Researchers say non-drug options such as exercise should be explored

It is the treatment most doctors recommend for back trouble.

But taking paracetamol has no effect on lower back pain, a major study shows.

Experts who examined the results of 13 research trials found that the drug did nothing to improve sufferers’ pain levels, recovery time, sleep or quality of life and was no more effective than a placebo or dummy pill.

Yet paracetamol is the first-line treatment for GPs dealing with acute attacks of lower back pain – the most common form of back ailment – while the website NHS Choices also advises patients to take it.

The study also found that paracetamol was of little benefit for those suffering with osteoarthritis and said taking the drug could raise the risk of liver problems.

Lower back pain is thought to affect two in five of us at some point.

It is triggered by bad posture while sitting or standing, bending awkwardly or lifting incorrectly.

In many cases it gets better within 12 weeks, with sufferers taking painkillers and keeping mobile.

However, despite universal advice to doctors about prescribing paracetamol, the review said there was no evidence it works.

Lead author Gustavo Machado of The George Institute and University of Sydney, said: ‘Paracetamol is the most widely used over-the-counter medicine for musculoskeletal conditions so it is critical that we review treatment recommendations in light of this new evidence.

In our research, paracetamol for low back pain and osteoarthritis was also shown to be associated with higher risk of liver toxicity in patients.

‘Patients were nearly four times more likely to have abnormal results on liver function tests compared to those taking placebo pills.’

The study, published in the BMJ, included 13 randomised controlled studies on more than 5,000 patients that looked at the effects of paracetamol compared with dummy pills for osteoarthritis of the hip or knee, and lower back pain.

Osteoarthritis expert Professor David Hunter of Sydney University said the review makes a case for revisiting paracetamol guidelines.

‘A separate study published recently has shown that paracetamol can be associated with an increasing incidence of mortality and increased risk of cardiovascular, gastrointestinal and renal disease in the general adult population,’ he said.
‘Clinicians should carefully weigh benefits and harms when making treatment decisions.

‘Paracetamol is not efficacious and potentially harmful. In this context we cannot justify its continued use for these prevalent diseases.’

Paracetamol, often taken for headaches, works by blocking enzymes in the brain and spinal cord involved in the transmission of pain.

As well as being sold in pill and capsule form, it is used in many over-the-counter cold and flu remedies.
The NHS spent £61million on paracetamol for GPs’ patients in 2011.

Published: 31 March 2015. By Jenny  Hope
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