Paracetamol may be ineffective for back pain and osteoarthritis

Paracetamol may not offer effective pain relief for back pain or osteoarthritis, according to a review published in the British Medical Journal.
Experts analysed studies involving over 5,000 patients that looked at the effects of paracetamol use compared with a pretend pill. They found that paracetamol had no effect for people with lower back pain and did not reduce disability or improve quality of life. When it came to osteoarthritis, the pain and disability benefits were small and not of clinical importance.
Paracetamol use for osteoarthritis was linked to a fourfold increase in the likelihood of having abnormal results on liver function tests. However, the clinical relevance of this was not established.
Because the longest follow-up period of any of the studies was only six months, further research is needed to determine the effects of the drug over a longer period of time but the researchers conclude:
“These results support the reconsideration of recommendations to use paracetamol for patients with low back pain and osteoarthritis of the hip or knee in clinical practice guidelines.”
The Medicines and Healthcare Products Regulatory Agency is carrying out a review of over-the-counter painkillers, including paracetamol, and until that work is completed, National Institute for Health and Care Excellence (NICE) says it will continue to recommend paracetamol as an option.
A spokeswoman from Arthritis Research UK comments:
“We’ve known for some time that paracetamol may not work for everyone with severe pain from their arthritis, but some people find it helps them, and allows them to sleep and to exercise without discomfort.
“Exercise, keeping moving and losing weight are effective ways in which people with osteoarthritis can help themselves. In fact, physical activity is probably a better and more effective way of keeping the pain of arthritis and joint pain at bay than taking currently available painkillers.
“People with arthritis who are concerned about taking paracetamol should consult their GP about alternative medications or other approaches to pain management, such as exercise and weight loss.”

Arthritis Digest reported on similar findings last year. Click here for more.

Image credit: Christian Prade

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