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Back Pain Relief with Acetaminophen is Same as Placebo, Study Finds

Jul 25, 2014

Taking acetaminophen to reduce back pain is no more effective than a placebo, a study published on Wednesday in The Lancet found. Acetaminophen is used as a minor pain reliever and fever reducer. It is sold under brand names such as Tylenol, Anacin and Panadol. Even though acetaminophen is used around the world for adults who have back pain, there has not been much research to back this recommendation, The New York Times reports.

The study was led by Dr. Christopher M. Williams, a researcher at the George Institute for Global Health in Sydney. “Our result illustrates the problems in relying on that indirect evidence when setting guidelines,” he said.

To conduct the study, Dr. Williams and his team gathered 1,643 people who suffered from acute lower back pain. These participants were randomly assigned to one of three groups. The first group received two boxes; there were 500-milligram acetaminophen tablets in the “regular” box as well as acetaminophen in the second “as-needed” box. The second group received one regular box of acetaminophen and an as-needed box containing a placebo. Two boxes of placebo were given to the third group.

Over the course of the three month study, all participants were instructed to take six tablets every day from the regular box. They were told to take up to two tablets from the as-needed box for extra pain relief. Overall, the researchers found no significant differences between the groups with recovery time, pain, disability, function, symptom changes, sleep or quality of life. Regardless of whether they received medicine, placebos, or both, about three-quarters of the patients were satisfied with the treatment they received.

The study was large and methodically conducted, but that does not necessarily mean that the findings are 100 percent conclusive, says Dr. Koes, a professor of general practice at Erasmus University Medical Center in Rotterdam, Netherlands. “The fact that it’s no more effective than placebo does not mean that it doesn’t work for a given patient,” said Koes in an accompanying editorial.

Headache, toothache and pain after surgery can still be effectively treated with acetaminophen, said Dr. Williams. The intricacies underlying back pain, however, are different and not well understood. He says that patients with acute low back pain should not be initially advised to take the drug. He also stated, according to NYT, “If patients already taking it feel they are getting a benefit, then it wouldn’t be wise to tell them to stop.”

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