Efficacy of paracetamol for acute low-back pain
Paracetamol is the recommended analgesic for acute low-back pain. However, there is no high-quality evidence to support this recommendation. This double blind randomised controlled trial aimed to investigate the efficacy of paracetamol for patients with acute low-back pain.
Participants in the regular group (N=550) were given paracetamol tablets in a regular box (every 6-8 hours) and placebo tablets in a as-needed box, when needed for pain relief (4-6 hours apart). The as-needed group (N=546) received placebo tablets in the regular box and paracetamol in the as-needed box and the placebo group (N=547) had placebo tablets in both boxes.
The findings showed that neither regular nor as-needed doses of paracetamol improved recovery, pain or any other outcomes compared to placebo at any stage during a 3-month follow up. The authors suggest that the efficacy of paracetamol in clinical practice should be carefully considered, with respect to the safe and effective use of other medicines. However, that advice and reassurance, rather than analgesics, should be the focus of first-line care of acute-low back pain.