Inefficacy of paracetamol in acute and chronic low back pain

SOURCE

Bruno T Saragiotto, et al. (2016) Paracetamol for Low Back Pain. Cochrane Database Syst Rev 7;6:CD012230.

CONTEXT

Paracetamol is the first-line treatment for patients with low back pain and recommended in many guidelines. However, these recommendations are not based on the results of studies that include patients with low back pain.

CLINICAL QUESTION

What is the antalgic effect of paracetamol in low back pain?

BOTTOM LINE

There is substantial evidence that the analgesic effect of paracetamol (4 g/d) is similar to placebo in patients with acute low back pain after 1, 2, 4 or 12 weeks of treatment. Besides, the effect on the quality of life, sleep and the need for rescue treatment were also found to be similar. Finally, no significant difference was noted regarding the rate of adverse effects.

In patients with chronic low back pain, paracetamol (1 gby taking) does not have an immediate analgesic effect (Level of evidence: low).

CAVEAT

The authors note the need for more studies in patients with chronic low back pain before removing the paracetamol from the guidelines.

AUTHOR INFORMATION

Yannick AUFFRET
Centre Hospitalier de Cornouaille
Quimper, France
y.auffret@ch-cornouaille.fr

Haldun AKOGLU
Marmara University Faculty of Medicine
Istanbul, Turkey
drhaldun@gmail.com