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, Australian researchers have found.
Low back pain is the leading cause of disability worldwide. 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.”
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 you may receive. Heat wraps and heat packs are simple methods that you can use to help with your 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 manual therapy (mobilisation/manipulation) can help control pain.