Canadian Chiropractor

Features Case Studies Clinical
Acetaminophen may have no effect on back pain relief: study


July 24, 2014
By Maria Cheng The Associated Press

Topics

acetaminophen-backpainJuly 24, 2014 – Acetaminophen isn't any better at relieving back pain than a fake pill, despite almost universal recommendations to take the drug, according to results from the first big trial to test it.

Acetaminophen, sold as Tylenol and Paracetamol, among other names, is
recommended in numerous guidelines for back pain, mainly because it has
few side effects; past studies have shown it works for other types of
pain. But there is no proof it is effective for lower back pain in
particular.

In a new study, Australian researchers assigned more
than 1,600 people with acute lower back pain to either acetaminophen –
to a maximum dose of 4,000 mg per day – or a placebo. Scientists found
no major difference in the time it took people to recover: Those on
acetaminophen got better after 17 days while those who took dummy pills
recovered after 16 days. The study focused on the kind of back pain most
people experience, resulting from lack of exercise, bad posture or a
strain.

The research was paid for by the Australian government
and GlaxoSmithKline Australia. It was published online Wednesday in the
journal, The Lancet.

“Most people would have thought
(acetaminophen) would have some effect, so this was a surprise,” said
Bart Koes of Erasmus MC University Center in the Netherlands, who
co-authored an accompanying commentary. He said doctors should monitor
people taking acetaminophen to see if the drug actually works.

Lower
back pain is the leading cause of disability worldwide and doctors
usually recommend treatments including painkillers, exercise,
stretching, physical therapy and old-fashioned remedies like hot and
cold packs.

“The mechanisms of back pain are likely to be
different from other pain conditions and this is an area that we need to
study more,” said Chris Williams of the University of Sydney in
Australia, the study's lead author, in an email.

“We know
exercise helps so people should stay as active as possible,” said Chris
Mercer, a physical therapist specializing in back pain and spokesman for
Britain's Chartered Society of Physiotherapy. “Don't just take to your
bed.”

Some doctors said it was too early to give up on
acetaminophen and said most people would get better within a week or two
whatever treatment they tried.

“Different strategies will work
for different patients,” said Dr. Nigel Mathers, honorary secretary of
Britain's Royal College of General Practitioners. “If (acetaminophen)
works for you, then continue to take it.”