Don't Waste Your Time Taking Acetaminophen for Back Pain or OA

Internal Medicine World Report, April 2015,

While acetaminophen can be credited with killing emotions, the same can't be said about back pain or osteoarthritis.

While acetaminophen can be credited with killing emotions, the same can’t be said about back pain or osteoarthritis.

Australian researchers gathered 13 randomized trials, which included 5,366 patients, in order to evaluate the safety and efficacy of acetaminophen and paracetamol. With osteoarthritis affecting almost 4% of the population and hip or knee specific being the 11th highest cause of global disability, the study aimed to give insight on the treatment option.

"Worldwide, paracetamol is the most widely used over-the-counter medicine for musculoskeletal conditions, so it is important to reconsider treatment recommendations given this new evidence." lead author Gustavo C. Machado, PhD student of The George Institute for Global Health, Sydney Medical School, and University of Sydney, said in a news release.

Out of the subjects, 3,541 had hip or knee osteoarthritis and the other 1,925 had low back pain. Two independent reviewers evaluated the data and the ratings for pain and disability were scored on a scale of 0 (none) to 100 (worst).

“We calculated weighted mean differences or risk ratios and 95% confidence intervals using a random effects model,” the study explained. “The Cochrane Collaboration’s tool was used for assessing risk of bias, and the GRADE approach was used to evaluate the quality of evidence and summarize conclusions.”

Published on The BMJ, the findings confirmed in the “high quality” results that the painkiller “does not deliver a clinically important benefit.” The study verified that this labeling means that acetaminophen did not even reach a score of 9 out of the 0 to 100 system.

The authors noted that although the data provided an understanding for short-term pain management, the effects of long term use have yet to be explored. While no drug is 100% safe, a pattern was discovered in the reviewed cases.

“Use of paracetamol for low back pain and osteoarthritis was also shown to be associated with higher risk of liver toxicity in patients,” Machado said.

Now that there is more evidence to bolster the claim of inefficiency and questions about the safety have been raised, new methods to manage pain sufficiently need to be further explored.