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A recent study about the pain relieving effects of paracetamol may surprise you.

Conclusion: paracetamol is no better than placebo at speedy recovery from acute episodes of low back pain or improving pain levels, function, or quality of life, according to the first large randomized controlled trial comparing the effectiveness of paracetamol with placebo for low back pain. The findings further question the universal endorsement of paracetamol as the first choice painkiller for low back pain according to the authors.

Williams CM et al. Efficacy of paracetamol for acute low back pain: at double-blind, randomized controlled trial. The Lancet, 2014; DOI: 10. 1016

The paracetamol for low back pain study (PACE): Randomized Control Trial (RCT) of 1652 subjects with an average age of 45 years with acute low back pain from 235 primary care centers in Australia receive up to four weeks of paracetamol (aka) acetaminophen randomized into three treatment groups:

  1. Regular doses consisted of three times per day the equivalent to 3990 mg per day
  2. As needed maximum 4000 mg per day or
  3. Placebo

All subjects received advising reassurance and were followed for three months.

Results: there are no differences in the number of days to recovery found between the treatment groups.

  1. median time to recovery was 17 days in the regular paracetamol group,
  2. 17 days envy as needed paracetamol group, 
  3. 16 days in the placebo group.

Paracetamol had no effect on short-term pain levels, stability function sleep quality or the quality of life.

The number of subjects reporting adverse events was similar between the groups.

The author conducting the study suggested simple analgesics, such as paracetamol, may not be of primary importance in the management of acute low back pain. The results suggest we need to re-consider the universalparacetamol recommendation as a first-line treatment for low back pain he added that it would be interesting to see whether advice and reassurance (as provided in our trial) might be a more effective treatment than pharmacological strategies for acute episodes of low back pain.