Featured Research

from universities, journals, and other organizations

Paracetamol no better than placebo for lower back pain

Date:
July 24, 2014
Source:
The Lancet
Summary:
Paracetamol is no better than placebo at speeding recovery from acute episodes of lower back pain or improving pain levels, function, sleep, or quality of life, according to the first large randomized trial to compare the effectiveness of paracetamol with placebo for low-back pain. The findings question the universal endorsement of paracetamol as the first choice painkiller for low-back pain, say the authors.

Paracetamol is no better than placebo at speeding recovery from acute episodes of lower back pain or improving pain levels, function, sleep, or quality of life, according to the first large randomised trial to compare the effectiveness of paracetamol with placebo for low-back pain. The findings, published in The Lancet, question the universal endorsement of paracetamol as the first choice painkiller for low-back pain, say the authors.

Related Articles


Low-back pain is the leading cause of disability worldwide. National clinical guidelines universally recommend paracetamol as the first choice analgesic for acute low-back pain, despite the fact that no previous studies have provided robust evidence that it is effective in people with low-back pain.

The Paracetamol for Low-Back Pain Study (PACE) randomly assigned 1652 individuals (average age 45 years) with acute low-back pain from 235 primary care centres in Sydney, Australia to receive up to 4 weeks of paracetamol in regular doses (three times a day; equivalent to 3990 mg per day), paracetamol as needed (maximum 4000 mg per day), or placebo. All participants received advice and reassurance and were followed-up for 3 months.

No differences in the number of days to recovery were found between the treatment groups -- median time to recovery was 17 days in the regular paracetamol group, 17 days in the as-needed paracetamol group, and 16 days in the placebo group. Paracetamol also had no effect on short-term pain levels, disability, function, sleep quality, or quality of life. The number of participants reporting adverse events was similar between the groups.

"Simple analgesics such as paracetamol might not be of primary importance in the management of acute lower back pain," said lead author Dr Christopher Williams from the George Institute for Global Health at the University of Sydney in Australia. "The results suggest we need to reconsider the universal recommendation to provide paracetamol as a first-line treatment for low-back pain, although understanding why paracetamol works for other pain states but not low-back pain would help direct future treatments."

He adds, "In view of the quick timeframe in which participants in our trial improved compared with other cohorts, it would be interesting to see whether advice and reassurance (as provided in our trial) might be a more effective than pharmacological strategies for acute episodes of low-back pain."

Writing in a linked Comment, Bart Koes and Wendy Enthoven from Erasmus MC, University Medical Center in Rotterdam, Netherlands say, "Williams and colleagues are to be applauded for tackling this research question on a topic that has been without debate and evidence for such a long time…Although the findings from this high-quality trial are clear, the content of guidelines should not be changed on the basis of a single trial; more robust and consistent evidence, including verification of the results in other populations, is needed…Furthermore, efforts to establish if prescription of other simple analgesics has additional benefit to advice and reassurance of the favourable prognosis for acute low-back pain are very welcome."


Story Source:

The above story is based on materials provided by The Lancet. Note: Materials may be edited for content and length.


Journal Reference:

  1. Christopher M Williams, Christopher G Maher, Jane Latimer, Andrew J McLachlan, Mark J Hancock, Richard O Day, Chung-Wei Christine Lin. Efficacy of paracetamol for acute low-back pain: a double-blind, randomised controlled trial. The Lancet, 2014; DOI: 10.1016/S0140-6736(14)60805-9

Cite This Page:

The Lancet. "Paracetamol no better than placebo for lower back pain." ScienceDaily. ScienceDaily, 24 July 2014. <www.sciencedaily.com/releases/2014/07/140724094025.htm>.
The Lancet. (2014, July 24). Paracetamol no better than placebo for lower back pain. ScienceDaily. Retrieved December 19, 2014 from www.sciencedaily.com/releases/2014/07/140724094025.htm
The Lancet. "Paracetamol no better than placebo for lower back pain." ScienceDaily. www.sciencedaily.com/releases/2014/07/140724094025.htm (accessed December 19, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Friday, December 19, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

The Best Tips to Curb Holiday Carbs

The Best Tips to Curb Holiday Carbs

Buzz60 (Dec. 19, 2014) It's hard to resist those delicious but fattening carbs we all crave during the winter months, but there are some ways to stay satisfied without consuming the extra calories. Vanessa Freeman (@VanessaFreeTV) has the details. Video provided by Buzz60
Powered by NewsLook.com
Sierra Leone Bikers Spread the Message to Fight Ebola

Sierra Leone Bikers Spread the Message to Fight Ebola

AFP (Dec. 19, 2014) More than 100 motorcyclists hit the road to spread awareness messages about Ebola. Nearly 7,000 people have now died from the virus, almost all of them in west Africa, according to the World Health Organization. Video provided by AFP
Powered by NewsLook.com
Researchers Test Colombian Village With High Alzheimer's Rates

Researchers Test Colombian Village With High Alzheimer's Rates

AFP (Dec. 19, 2014) In Yarumal, a village in N. Colombia, Alzheimer's has ravaged a disproportionately large number of families. A genetic "curse" that may pave the way for research on how to treat the disease that claims a new victim every four seconds. Duration: 02:42 Video provided by AFP
Powered by NewsLook.com
Double-Amputee Becomes First To Move Two Prosthetic Arms With His Mind

Double-Amputee Becomes First To Move Two Prosthetic Arms With His Mind

Buzz60 (Dec. 19, 2014) A double-amputee makes history by becoming the first person to wear and operate two prosthetic arms using only his mind. Jen Markham has the story. Video provided by Buzz60
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins