Back pain: Acetaminophen no better than placebos

A large-scale, rigorous study published in the Lancet found that the go-to, front-line treatment for back pain was no better than a placebo.

We did a multicentre, double-dummy, randomised, placebo controlled trial across 235 primary care centres in Sydney, Australia, from Nov 11, 2009, to March 5, 2013. We randomly allocated patients with acute low-back pain in a 1:1:1 ratio to receive up to 4 weeks of regular doses of paracetamol (three times per day; equivalent to 3990 mg paracetamol per day), as-needed doses of paracetamol (taken when needed for pain relief; maximum 4000 mg paracetamol per day), or placebo. Randomisation was done according to a centralised randomisation schedule prepared by a researcher who was not involved in patient recruitment or data collection. Patients and staff at all sites were masked to treatment allocation. All participants received best-evidence advice and were followed up for 3 months. The primary outcome was time until recovery from low-back pain, with recovery defined as a pain score of 0 or 1 (on a 0—10 pain scale) sustained for 7 consecutive days. All data were analysed by intention to treat. This study is registered with the Australian and New Zealand Clinical Trial Registry, number ACTN 12609000966291.

Efficacy of paracetamol for acute low-back pain: a double-blind, randomised controlled trial [Dr Christopher M Williams PhD, Prof Christopher G Maher PhD, Prof Jane Latimer, Prof Andrew J McLachlan PhD, Mark J Hancock PhD c, Prof Richard O Day MD, Chung-Wei Christine Lin PhD/The Lancet]

(Image: Hydrocodone, Guian Bolisay, CC-BY-SA)