Paracetamol used
to treat acute lower back pain is no better than a dummy pill, research in the
Lancet suggests.
The largest trial to date suggests
the drug does not improve recovery time or provide greater pain relief than a
placebo.
The study questions whether
paracetamol should remain a first-choice drug on most national guidelines.
But experts caution anyone
considering a change of medication should seek medical advice.
Paracetamol does
not work for every type of pain, nor does it work for every person”
Dr Andrew Moore Churchill
Hospital, Oxford
About 26
million people suffer from lower back pain each year in the UK, and it remains
a leading cause of disability worldwide.
Sleep quality
Researchers studied more than 1,650
people across several primary care centres in Australia, who had experienced
back pain for six weeks or less.
- A third received regular doses of paracetamol
- A third took the drug as needed
- A third were given a dummy pill (placebo) for one month
Paracetamol did not reduce the
intensity of the pain, nor did it improve sleep quality. And scientists found
there was no difference in recovery time for all three groups - an average of
17 days.
Lead author Dr Christopher
Williams, from the University of Sydney, said: "The results suggest we
need to reconsider the universal recommendation to provide paracetamol as a
first-line treatment."
'Remain active'
The researchers say the mechanisms
behind lower back pain may differ to those in pain felt in other conditions
such as headaches, toothaches and post-surgery discomfort - where there is
evidence that paracetamol can provide relief.
And as people in the trial
recovered more quickly than those in some previous studies, they suggest the
advice and reassurance provided during their trial may be more effective than
medication.
Dr Andrew Moore, a senior
researcher at the Churchill Hospital, Oxford, who was not involved in the
research, told the BBC: "Paracetamol does not work for every type of pain,
nor does it work for every person.
"There has been evidence
emerging for some time that paracetamol does not benefit most people with
chronic back pain for example.
"And I'm willing to bet in 10
years' time national guidelines will have changed."
However, the researchers were
unsure what to recommend instead due the side-effects of some anti-inflammatory
pain killers and say people should discuss their options with their doctor.
Prof Roger Knaggs of the British
Pain Society, told the BBC: "Despite how common paracetamol use is, this
is a question that hasn't been studied in such a rigorous way before.
"For people who feel no
benefit, there are alternative strategies. They should speak to their
pharmacists or doctors and discuss any side-effects of other medication."
Prof Christine Lin, an author on
the study, said: "Other ways to ease back pain include remaining as active
as possible and avoiding bed rest."
(BBC)