Paracetamol Does Not Alleviate Lower Back Ache

Paracetamol does no good in recovery of acute episodes of lower back pain or improving pain levels, function, sleep, or quality of life, a new research shows.

Paracetamol is often taken to relieve lower back pain, the leading cause of disability worldwide.

The Paracetamol for Low-Back Pain Study (PACE) was randomly assigned to 1,652 people with average age 45 years in a study. All the participants had acute low-back pain. They were recruited for the study from 235 primary care centres in Sydney, Australia and for 4 weeks they received 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 were given advice and reassurance and were followed-up for 3 months, the study authors explained in a press release.

Researchers found no differences in the number of days to recovery between the treatment groups. The average time of recovery was 17 days in the regular paracetamol group, 17 days in the as-needed paracetamol group, and 16 days in the placebo group.

The team noted that paracetamol did not alleviate the 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."

"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," he added.

The study was published in The Lancet.