Research published in the Lancet suggests that paracetamol used for the treatment of acute lower back pain is as effective as a dummy pill.
The results of the largest trial to date indicate that the drug does not provide more pain relief or improve recovery time than a placebo.
The study questions whether paracetamol should remain the first-choice drug on national guidelines. However, experts caution those who are considering a change in medication to obtain medical advice.
Around 26 million people in the UK suffer from lower back pain and it is a leading cause of global disability.
The research involved 1650 participants across many primary care centres within Australia, who had suffered back pain for six weeks or less, and found:
• One third took the drug as needed
• One third were provided with regular paracetamol doses
• One third was provided with a placebo (dummy pill) for a month
It was discovered that paracetamol did not reduce the level of pain or improve the sleep quality. Scientists found that there was no variance in the recovery time of 17 days for the three groups.
The lead author of the study, from the University of Sydney, Dr Christopher Williams, said the results indicated that the universal recommendation of paracetamol as a first-line treatment should be reconsidered.
The scientists stated that the mechanisms affecting lower back pain may be different to those in pain from other conditions, such as toothaches, post-surgery discomfort and headaches, where paracetamol has been found to be effective.
Trial participants appeared to recover more quickly than participants in previous studies and this suggests that the reassurance and advice offered during the trial may be more effective than drugs.
A senior researcher at the Churchill Hospital, Oxford, Dr Andrew Moore, said paracetamol is not effective for all pain types, and it is not suitable for every person. Dr Moore was not involved in the research. He said that there has been evidence that paracetamol is not effective in chronic back pain. He is willing to bet that in a decade’s time the national guideline will have changed.
The researchers are unsure what to recommend instead of paracetamol as there are many side-effects linked to some anti-inflammatory painkillers. They have recommended that patients discuss their options with their medical adviser.
Professor Roger Knaggs from the British Pain Society said that although the use of paracetamol is extremely common, this fact has not been studied in such a detailed manner previously. He said that people who do not benefit from it should seek alternative strategies. They should discuss their needs with doctors or pharmacists and discuss the side-effects of other medication.
An author on the study, Professor Christine Lin, said that other methods to relieve back pain include avoiding bed rest and being as active as possible.
Image Credit: Sarah