A Cochrane review [Abstract] 1 included 3 studies with a total of 1825 subjects. Two trials included participants with acute back pain and one participants whose pain lasted for longer than six weeks (chronic). Most of the people in the study (90%) were middle-aged and came from a single trial that looked at acute back pain. The treatments ranged from a single 1g dose (given intravenously) up to 4g in a 24 hour period for up to four weeks (oral tablets). Participants were followed between one day and 12 weeks. Two trials were included in the meta-analysis.
In acute LBP, paracetamol (4g per day) was no better than placebo for relieving acute LBP in either the short or longer term. It also worked no better than placebo on the other aspects studied, such as quality of life and sleep quality. About one in five people reported side effects, and there was no difference between intervention and control groups. The reported serious adverse events were unrelated to the study treatment (for example asthma attack, bleeding bowel, infection, hernia, severe back pain, or scheduled surgery)
There appears to be no difference between paracetamol and placebo in immediate reduction of chronic LBP, although the evidence is of very low quality, and the single study on which it is based has been withdrawn by the journal.
| Outcome | Relative effect(95% CI) | Assumed risk - control=placebo | Corresponding risk - intervention=paracetamol | Number of participants (studies) |
|---|---|---|---|---|
| Pain1 week (immediate term)(NRS 0 to 100) | The mean pain in the control group was36 points | The mean pain in the intervention group was1.49 higher(1.30 lower to 4.28 higher) | 1520 (1 study) | |
| Pain12 weeks (short term)(NRS 0 to 100 | The mean pain in the control group was13 points | The mean pain in the intervention group was0.50 lower(2.92 lower to 1.92 higher) | 1526 (1 study) | |
| Disability1 week (immediate term)(RMDQ 0 to 24) | The mean disability in the control group was8.3 points | The mean disability in the intervention group was0.45 lower(1.15 lower to 0.25 higher) | 1511 (1 study) | |
| Disability12 weeks (short term)(RMDQ 0 to 24) | The mean disability in the control group was2.4 points | The mean disability in the intervention group was0.10 higher(0.39 lower to 0.59 higher) | 1522 (1 study) | |
| Any adverse eventsup to 12 weeks' follow-up | RR 1.07(0.86 to 1.33) | 107 per 1000 | 115 per 1000 (92 to 142) | 1624 (1 study) |
| Serious adverse eventsup to 12 weeks' follow-up | RR 0.90(0.30 to 2.67) | 90 per 1000 | 91 per 1000 (90 to 93) | 1643 (1 study) |
Date of latest search: 2015-08-01
Primary/Secondary Keywords