Paracetamol not effective to treat back pain
In a study that has far reaching implications for clinical practice in different countries of the world including India, a new study has found that paracetamol, the pain relief medicine that is universally recommended to treat people with, acute low back pain, does not speed recovery or reduce pain for this condition.
Low back pain is the leading cause of disability worldwide. In India on any given day, 8.4% of population, or 100 million people, will suffer from low back pain.
Every back pain treatment guideline in the world currently recommends the use of paracetamol , as the first-line back pain analgesic, despite the fact that no previous studies have provided convincing evidence that it is effective in people with low back pain.
“In the world’s first large placebo-controlled trial, we have demonstrated that taking paracetamol does not speed recovery or reduce pain compared to placebo,” said senior author Associate Professor Christine Lin, of The George Institute for Global Health and The University of Sydney. “The effect is the same whether paracetamol is taken regularly or as required.”
“Because low-back pain is the leading cause of disability worldwide, this study shows that improved focus on development of new, effective treatments is warranted.”
Associate Professor Lin said the reasons for paracetamol failing to work for low-back pain are not well understood.
“While we have shown that paracetamol does not speed recovery from acute back pain, there is evidence that paracetamol works to relieve pain for a range of other conditions, such as headaches, some acute musculoskeletal conditions, tooth ache and for pain straight after surgery. Paracetamol is also effective in reducing fever. What this study indicates is that 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.”
Commenting on the findings of the study, Professor Vivekanand Jha, Executive Director, The George Institute for Global Health India, said: “Back pain is a disabling condition for those who suffer from it, and indiscriminate use of analgesics has the potential to cause a number of drug-related adverse effects including damage to liver and kidneys. A careful risk-benefit analysis, therefore, is important for appropriate management of this common condition.”
What other options are there for acute low back pain?
Associate Professor Lin says it is important to remain as active as possible and avoid bed rest. “An active approach is probably more important than any therapy they may receive. Heat wraps and heat packs are simple methods that the person can use to help with their pain.
“If that simple approach does not help you can talk to your pharmacist or doctor about other pain medicines, but you do need to carefully follow their advice as these medicines can have serious side effects. There is also some evidence that a short course of spinal manipulation can help control pain.
The study, published today in the prestigious publication The Lancet, looked at 1,643 people experiencing acute uncomplicated low back pain and presenting to primary care in Australia.
Read more about the study on The George Institute Australia website.