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Tylenol ineffective for low back pain relief reports new study

The study demonstrates the placebo effect: if an individual believes that a medication can have a benefit, the benefit may be experienced
The study demonstrates the placebo effect: if an individual believes that a medication can have a benefit, the benefit may be experiencedRobin Wulffson, MD

Tylenol and its generic equivalents (acetaminophen in the US; paracetamol in Europe and Australia) is commonly taken for relief of low back pain; however a new Australian study found that the drug was no more effective than a placebo for relieving acute (sudden onset) low back pain. The study demonstrates the placebo effect: if an individual believes that a medication can have a benefit, the benefit may be experienced. The study was published online on July 23 in the journal The Lancet.

The investigators described es1 describe the findings of the Paracetamol for Low-Back Pain Study (PACE), which found that paracetamol was not more effective than a placebo in patients with acute low-back pain. The study comprised 1,652 patients with acute low-back pain who were randomly assigned to receive paracetamol in regular doses, paracetamol as needed, or a placebo. None of the participants were aware whether they were taking paracetamol or a placebo; they took the medication until they were pain-free (up to four weeks).

The patients in all three groups took about the same number of days to become pain-free: 17 days in both the regular-dose group and the as-needed group, and 16 days in the placebo group. All participants recorded their daily pain (on a scale of 1 to 10). The pain scores for all three groups were comparable throughout the study. , and pain scores across the three groups were about the same throughout the study.

Two studies published earlier this year addressed low back pain. Both studies were published online on March 24 in the Annals of the Rheumatic Diseases. One reported that low back pain causes more disability than nearly 300 other conditions worldwide; furthermore, about 1 in 10 individuals across the globe suffers from an aching lower back. The other, which looked at specific types of jobs, found that low back pain is responsible for about a third of work-related disability. Older age, low education, obesity, having stress, anxiety or depression, as well as occupations that require significant heavy lifting or are extremely stressful, are all factors that increase the risk of low back pain.

Most back pain, even severe back pain, goes away on its own in two to four weeks. Surgery is rarely needed for back pain and is generally considered only as a last resort. If the pain is due to an injury such as a strain, an ice pack should be used for the first 24 hours to minimize swelling. Then, heat should be applied to promote blood circulation and healing.