The first thing that many people do when they feel minor aches in their body or suffer from fever is to reach out for acetaminophen, or paracetamol, to ease their condition. Unfortunately for those who use paracetamol to treat their back pain, the medication may not be as effective as many believe it to be.

A large-scale randomized trial that compared the effectiveness of paracetamol, which is available in brand names such as Tylenol and Panadol, and placebo for treating low back pain, suggests that taking the drug during episodes of acute low back pain is no more than helpful than not taking the medication at all.

For the study published in The Lancet on July 24, Chris Maher, from the University of Sydney's George Institute for Global Health, and colleagues randomly assigned more than 1,600 individuals with acute-low back pain, who were 45 years old on average, to take for up to four weeks paracetamol thrice a day, which is equivalent to 3990 mg daily, take up to 4000 mg of paracetamol when need to relieve pain, or placebo.

After three months, the researchers observed that taking paracetamol did not improve the sleep quality and quality of life of the participants. No difference were also observed in symptom changes, disability, function and short term pain levels among patients in the three groups. The number of patients who reported adverse events was likewise the same across the groups and about three quarters of the patients in each of the three groups were satisfied with their treatment.

"Surprisingly found that it didn't really matter whether you gave people placebo as required, paracetamol or time contingent, that is regular paracetamol, there was no difference in any of the outcomes," Maher said during an interview. "It didn't speed time to recovery; it didn't improve their pain; it didn't improve their disability."

Maher and colleagues also found that there were no significant differences in all three groups in terms of recovery time. The recovery time of those who took paracetamol three times a day was 17 days, which is the same as those who only took paracetamol when need. The participants who received placebo, on the other hand, recovered in 16 days.

"Our findings suggest that regular or as-needed dosing with paracetamol does not affect recovery time compared with placebo in low-back pain, and question the universal endorsement of paracetamol in this patient group," the researchers concluded.

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