Lower back pain? Paracetamol is no better than placebo for pain, sleep or recovery, says large new study

Paracetamol is no better than placebo for speeding recovery from acute episodes of lower back pain or improving pain levels, function, sleep or quality of life, says research published in The Lancet. It’s the first large randomised trial to compare the effectiveness of paracetamol with placebo for lower back pain, and questions the universal endorsement of paracetamol as the first choice painkiller for lower back pain.
A total of 1,652 people from Sydney, Australia (average age 45 years) with acute lower back pain were split into three groups:

• Paracetamol three times a day (total of 3,390mg/day) for four weeks
• Paracetamol as needed (maximum 4,000 mg per day) for four weeks
• Placebo for four weeks

All participants received advice and reassurance and were followed-up for three months.
All three groups took about the same amount of time to recover (17 days in the regular paracetamol group, 17 days in the as-needed paracetamol group and 16 days in the placebo group).
And paracetamol had no effect on short-term pain levels, disability, function, sleep quality or quality of life.
“Simple analgesics such as paracetamol might not be of primary importance in the management of acute lower back pain,” explains Dr Christopher Williams, lead author. “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.”

Click here to read the original research.