Acetaminophen: No gain for back pain?

Aug. 6, 2014—What do you take when your lower back aches? If it’s acetaminophen, you might not get the help you’re looking for, according to a study published in The Lancet. Researchers found that this over-the-counter medication doesn’t tend to reduce pain or shorten healing times for people with some types of back troubles.

About the study

To test whether acetaminophen is effective in relieving acute low-back pain, researchers in Australia analyzed 1,643 people who had this type of pain. The participants were each assigned to one of three groups: Group one was given acetaminophen on a set schedule and received a placebo for as-needed doses. Group two received acetaminophen on an as-needed basis and a placebo on a set schedule. Group three took only a placebo. All participants took their doses for up to four weeks, and they were encouraged to remain active and avoid bed rest. The participants did not know which group they were in.

When compared to people who took a placebo, those in both groups who received acetaminophen:

  • Did not have lower levels of pain
  • Did not see improvement in quality-of-life issues like sleep or the ability to move around
  • Did not have shorter recovery times

The researchers concluded that, compared to taking a placebo, taking acetaminophen for acute low-back pain has no effect.

Read a summary of the study here.

The take-home message
This study suggests that you may want to reconsider taking acetaminophen for acute low-back pain or discuss it with your doctor. Meanwhile, these basic self-care techniques may help:

Apply cold compresses. As soon as your back begins to hurt, place a cold pack or a bag of frozen vegetables wrapped in a towel over the tender spot. Keep it there for up to 20 minutes, and repeat this treatment several times each day for two or three days.

Try heat therapy. After two to three days of applying cold packs, use a heating pad for brief periods (during waking hours only, to avoid burns) or try sliding into a warm bath. This may relax your muscles and increase blood flow.

Exercise. Staying active may speed your recovery by helping to strengthen your back and abdominal muscles. Gentle stretching exercises, walking and swimming are good options. However, if your pain lasts longer than 15 minutes while you’re exercising and you would describe it as more than mild discomfort, stop what you’re doing and call your doctor.

Limit bed rest. Staying in bed might actually make your back worse, so limit bed rest to one to two days at the most.

The good news is that acute low-back pain usually goes away within a few days, according to the National Institute of Neurological Disorders and Stroke. However, if self-care doesn’t ease your pain within 72 hours, see your doctor. Depending on your diagnosis, you may be a candidate for other treatments.

To find out more about when you should see a doctor for back pain, take this assessment.


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