Study suggests Acetaminophen doesn’t reduce back pain

A new study published in The Lancet by a team of Australian researchers suggests that the popular pain-reliever acetaminophen has no effect on acute lower back pain. This over-the-counter drug has been widely recommended by medical professionals to deal with this condition. Lower back pain is an extremely common complaint in the United States and one of the leading causes of disability worldwide.¹ Back pain is a common reason for U.S. citizens to miss work or seek medical attention. Though there are a number of methods for coping with acute lower back pain, acetaminophen is often recommended because it is relatively safe and has few side effects. Though acetaminophen has been proven to help alleviate other types of pain, no study had been conducted to confirm that it lessened lower back pain. This is leading scientists and medical professionals to reconsider how to guide patients to manage this nearly universal ailment. This challenge will likely fall on those in the field of pharm tech to design new, safe drugs for dealing with lower back pain.

The study

The study was conducted by researchers from various universities and funded by the National Health and Medical Research Council of Australia and GlaxoSmithKline Australia.² Using patients from 235 primary care facilities near Sydney, Australia, researchers divided test subjects into three groups: those who would take acetaminophen regularly, those who would take the painkiller as needed, and a placebo group. Each group consisted of approximately 550 patients. These test subjects were then monitored over several weeks and reported their total level of pain on a scale from 0-10. The scientists compared the average number of days it took each group of patients to reach full pain relief, defined as a ranking of 0 or 1 on the pain scale.³

Researchers found that the median recovery time in both the regular and as-needed groups was 17 days, whereas the median recovery time in the placebo group was only 16 days.⁴ Scientists interpreted this data as evidence that acetaminophen has little effect on acute lower back pain, and that the universal endorsement of this drug may be completely unwarranted.

Methods for coping with acute lower back pain

Lower back pain often causes many people to resort to bed rest. However, exercise and several other simple methods have been recommended for dealing with this sometimes chronic condition. Common practices for coping with acute lower back pain include:

• Hot and cold packs: When it comes to lower back pain, hot and cold packs are generally a home remedy with no guaranteed medical results. Studies have shown that hot packs are more effective than cold packs, but most people recommend switching between these two extremes. Moist heating sources such as a hot shower, bath, or damp heating pad are advised in 15 to 20 minute increments. Consult with a doctor to learn if your back pain requires hot or cold therapy.
• Exercise: Low impact aerobic exercise has been proven to help strengthen the back and reduce the risk of lower back pain. A regular exercise regimen of activities such as walking or swimming will increase muscle functionality. Consult with a doctor to create a personal aerobic routine that suits your specific health needs.⁵
• Stretching: Numerous stretches can be found online for coping with lower back pain. Paired with regular exercise, stretching can help increase back strength and endurance. However, consult with a physician or physical therapist to learn specific stretches and exercises.
• Alternative therapy: Symptoms of lower back pain may be eased by alternative therapy methods such as acupuncture, chiropractic care, massage and yoga.^6 ​

However, despite the findings of this study, it is likely painkillers will continue to be the most recommended treatment option. NSAIDs have also been recommended for coping with acute lower back pain, but as the drugs are associated with more risks and side effects, they have not been as strongly endorsed. Furthermore, as this is the first study focused on the effects of acetaminophen on lower back pain, more robust research must be undertaken before any major conclusions can be made.

NSAIDs

NSAIDs, or nonsteroidal anti-inflammatory drugs, include common drugs such as ibuprofen and naproxen sodium. Ibuprofen is the technical name for Advil and Motrin, along with other well-known painkillers. NSAIDs are designed to reduce pain and inflammation. While low dosages of NSAIDs are available over the counter, more powerful painkillers require a prescription. NSAIDs are not recommended as highly as acetaminophen due to a potentially increased risk of heart disease and stroke. If more conclusive evidence eventually proves acetaminophen is ineffective for reducing lower back pain, pharmaceutical companies will likely have to find new drugs to help cope with this problem on a large scale.

¹“Acetaminophen no better than placebo for back pain, study finds” CBS News. July 24, 2014. http://www.cbsnews.com/news/acetaminophen-no-better-than-placebo-for-back-pain-study-finds/

²“Efficacy of paracetamol for acute low-back pain: a double-blind, randomised controlled trial” by Dr Christopher M Williams PhD, Prof Christopher G Maher PhD, Prof Jane Latimer, Prof Andrew J McLachlan PhD, Mark J Hancock PhD, Prof Richard O Day MD, Chung-Wei Christine Lin PhD. The Lancet. July 24, 2014. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60805-9/abstract

³“Efficacy of paracetamol for acute low-back pain: a double-blind, randomised controlled trial” by Dr Christopher M Williams PhD, Prof Christopher G Maher PhD, Prof Jane Latimer, Prof Andrew J McLachlan PhD, Mark J Hancock PhD, Prof Richard O Day MD, Chung-Wei Christine Lin PhD. The Lancet. July 24, 2014. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60805-9/abstract

⁴“Efficacy of paracetamol for acute low-back pain: a double-blind, randomised controlled trial” by Dr Christopher M Williams PhD, Prof Christopher G Maher PhD, Prof Jane Latimer, Prof Andrew J McLachlan PhD, Mark J Hancock PhD, Prof Richard O Day MD, Chung-Wei Christine Lin PhD. The Lancet. July 24, 2014. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60805-9/abstract

⁵“Back Pain Prevention” by Mayo Clinic Staff. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/back-pain/basics/prevention/con-20020797

⁶“Back Pain Alternative Medicine” by Mayo Clinic Staff. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/back-pain/basics/alternative-medicine/con-20020797