Paracetamol (Acetaminophen) No Better than Placebo for Low Back Pain.

by / Thursday, 02 April 2015 /

paracetamolEfficacy and safety of paracetamol for spinal pain and osteoarthritis: systematic review and meta-analysis of randomized placebo controlled trials.

Gustavo C Machado, Chris g Maher, Paulo H Ferreira, Marina B Pinheiro, Chung-Wei Christine Lin, Richard O Day, Andrew j McLachlan, Manuela L Ferreira

British Journal of Medicine 2015; 350:h1225 doi:10.1136


Researchers have found that paracetamol (acetaminophen) is not effective vs. placebo in the treatment of low back pain. The study published in the BMJ, included 13 randomized controlled studies with over 5,300 patients.

Globally low back pain affects almost 10% of the population (1) (2).Prescription drugs like paracetamol (acetaminophen) are the most commonly prescribed treatment for low back pain and is described as a first line agent in many guidelines across the US and Europe for the treatment of low back pain.

Reduction of pain intensity, improvement of disability and quality of life as well as safety and patient adherence was accessed. The study showed that its use in the treatment of low back pain that had no effect and did not reduce disability or improve quality of life compared with the use of a placebo. Similarly, adherence rates between paracetamol and placebo where found to be the similar and there was no difference in regards to adverse effects of paracetamol compared to a placebo.

The study did point out that paracetamol treatment for low back pain was associated with a higher risk of liver toxicity and patients were nearly four times likely to have abnormal liver function test than patients taking placebo. Recently in the US, the FDA has determined that acetaminophen doses greater than 4,000 mg/day are unsafe.



  1. The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Hoy D, March L , Brooks P, et al. 73, 2014, Ann Rheum Dis, pp. 968-74.
  2. The global burden of neck pain:estimates from the global Burden of Disease 2010 study. Hoy D, March L, Woolf A et al. 73, 2014, Ann Rhuem Dis, pp. 1309-15.


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