Paracetamol is not effective in the treatment of spinal pain and provides negligible benefits for osteoarthritis, according to an Australian study published today in the BMJ.
The findings are at odds with clinical guidelines that recommend paracetamol as the first line drug treatment for both conditions.
Lead author Gustavo Machado from The George Institute for Global Health at the University of Sydney carried out a systematic review and meta-analysis to examine the efficacy and safety of paracetamol for lower back pain and osteoarthritis of the hip or knee.
The study included 13 randomised controlled studies that looked at the effects of paracetamol use compared with a placebo: 10 trials included 3,541 patients and evaluated the use of paracetamol for osteoarthritis of the hip or knee, and three trials included 1,825 patients on the use of paracetamol for lower back pain.
The study showed that for lower back pain, paracetamol had no effect and did not reduce disability or improve quality of life compared with the use of a placebo. For osteoarthritis, they found small, but not clinically important benefits in the reduction of pain and disability compared with the use of a placebo.
Paracetamol use for osteoarthritis was also shown to increase the likelihood of having abnormal results on liver function tests by almost four times compared with a placebo, but the clinical relevance of this is still not certain, explain the authors.
Bill Condie is a science journalist based in Adelaide, Australia.
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