Tylenol & Back Pain
The 160 million Americans who suffer from low back pain every year, especially those whose go-to for relief is acetominophen (aka Tylenol/Paracetamol), might be surprised to find out that the medications they’re taking are causing more problems than they’re fixing.
Acetominophen is recommended in numerous guidelines for back pain, mainly because it has fewer side effects than NSAIDs and other painkillers. However, there’s been very little evidence to support the recommendation, and now a large, rigorous trial published in the prestigious medical journal The Lancet has shown that those medicines are actually no more helpful than swallowing a sugar pill.
In the study, the Australian researchers took about 1600 individuals with acute low back pain and assigned them into one of three groups:
- Tylenol 3x daily (4,000mg per day)
- Tylenol only as needed
Over the course of three months, the researchers found that there was actually zero benefit to taking Tylenol compared to placebo. There was no significant difference in recovery time, pain, disability, function, symptom changes, sleep or quality of life between the groups. About 75% of the patients reported that they were satisfied with their treatment whether they received medicine, placebos or both.
The researchers summarized their surprising findings:
“Our findings suggest that regular or as-needed dosing with paracetamol [acetaminophen] does not affect recovery time compared with placebo in low-back pain, and question the universal endorsement of paracetamol in this patient group.”
“The results suggest we need to reconsider the universal recommendation to provide acetominophen as a first-line treatment for low-back pain,”
What’s more, other recent research has shown that in prolonged use, acetaminophen causes many of the same side effects to the stomach lining as other NSAIDs (ibuprofen, aspirin), without actually getting results.
What Does Work For Back Pain?
As more and more research on treating back pain is published, it’s quickly becoming apparent that the best treatment for back pain doesn’t involve pills at all. Chiropractic care (surprise, surprise) has been shown to be safe, effective at reducing pain (decreasing the need for medication), rapidly advances physical therapy, and it doesn’t require long recovery times or bed rest.
In fact, after an extensive study of all available care for low back problems, the federal Agency for Health Care Policy and Research now suggests that low back pain sufferers choose the most conservative care first. And it recommends spinal manipulation as the only safe and effective, drugless form of initial care for acute low back problems in adults.
The American College of Physicians (ACP), the world’s largest medical society, also updated its low-back pain treatment guidelines in 2017 to support a conservative approach to care. Published in the Annals of Internal Medicine and based on a review of randomized controlled trials and observational studies, the ACP guidelines cite chiropractic care one of the best options for non-invasive, non-drug treatment for low back pain. The guidelines state that ‘only when such treatments provide little or no relief should patients move on to medicines such as ibuprofen or muscle relaxants, which research indicates have limited pain-relief effects’.
The Bottom Line
Looking at chiropractic care’s excellent clinical track record for low back pain and considering the alternatives, it’s an easy decision. Don’t have a chiropractor? We’d love to help you get started. Make an appointment at Ascent Chiropractic in Brookfield by calling 262-345-4166 or schedule an appointment with our online scheduling app.
Williams CM, et al. Efficacy of paracetamol for acute low-back pain: a double-blind, randomised controlled trial. The Lancet, July 24, 2014.