Bruno T Saragiotto, et al. (2016) Paracetamol for Low Back Pain. Cochrane Database Syst Rev 7;6:CD012230.
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.
What is the antalgic effect of paracetamol in low back pain?
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).
The authors note the need for more studies in patients with chronic low back pain before removing the paracetamol from the guidelines.
Centre Hospitalier de Cornouaille
Marmara University Faculty of Medicine