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Pain Management Health Center

Acetaminophen May Not Help Against Back Pain, Study Contends

The common pain reliever, best known as Tylenol, showed no effect in Australian trial
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The researchers pointed out the maximum daily dose of the drug is 4,000 milligrams (mg).

All of the patients received follow-up "reassurance and advice" from a doctor for three months.

According to the study, there were no differences in the amount of time it took any of the patients involved in the study to feel better. The median time to recovery for those taking acetaminophen was 17 days, compared to 16 days for patients in the placebo group.

The drug also appeared to have no effect on the patients' level of pain, compared to people who took the dummy pill, the researchers noted. Acetaminophen also did not improve patients' level of disability, sleep quality or quality of life. About the same number of patients in each group experienced negative health issues, the study found.

The researchers suggested that the medical reassurance the patients received during the study -- something many won't get in a "real world" setting -- could have had a more significant effect on their lower back pain than the medication.

"It would be interesting to see whether advice and reassurance [as provided in our trial] might be more effective than pharmacological strategies for acute episodes of low-back pain," Williams said.

Another expert agreed that encouragement and counseling can be key.

Everyone involved in the study received ongoing " 'good-quality advice and reassurance,' which appears to be a big factor in recovery," said Dr. Michael Mizhiritsky, a physiatrist and specialist in pain relief at Lenox Hill Hospital in New York City.

"In my opinion, positive reinforcement about treatments -- including medications and physical therapy -- in the management of low back pain is vital to a quicker and successful recovery," he added.

Both Danesh and Mizhiritsky also took issue with some of the study's methods.

"The drawback I see is there was no group that did not receive any treatment -- meaning there could be a placebo effect" at work, Mizhiritsky said.

And Danesh said people could still get relief from acetaminophen/Tylenol -- just not the kind of relief outlined in the study.

"The criteria was to be pain-free for seven continuous days when using Tylenol," he pointed out. "It does not address if Tylenol will give you a few hours of relief or a few days."

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