• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Chronic Disease

Paracetamol (Tylenol) ineffective for low-back pain [PACE Study]

byTony JiangandStefan Trela
July 24, 2014
in Chronic Disease
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

1. Paracetamol taken regularly or as needed for low-back pain did not affect recovery time compared with placebo.

Evidence Rating Level: 1 (Excellent)

Study Rundown: Although paracetamol is universally recommended as the first-line analgesic for low-back pain, no high-quality evidence has supported this recommendation. The Paracetamol for Low-Back Pain Study (PACE) assessed the efficacy of paracetamol compared to placebo when taken regularly or as needed for low-back pain. Patients with acute low-back pain were randomized to receive either 4 weeks of paracetamol, paracetamol as needed, or placebo, and followed up for three months. Recovery was defined as a pain score of 0 or 1 out of a 0-10 pain scale for 7 consecutive days.

Regardless of whether paracetamol was taken regularly or as needed, there was no significant difference compared to placebo in minimizing recovery time from low-back pain. Strengths of this study included a large sample size of over 500 participants in each group and the study was adequately powered to detect a difference of 3 days in median time to recovery. Limitations of the study include the fact that participants typically took a lower median dose than the maximum recommended dose, which may have affected the efficacy. The authors suggest that the universal recommendation of paracetamol for use in patients with low-back pain be reconsidered, however, further studies should be conducted before completely dismissing paracetamol as a treatment for low-back pain.

This study was funded by the National Health and Medical Research Council of Australia and GlaxoSmithKline Australia.

Click to read the study, published today in The Lancet

Relevant Reading: An updated overview of clinical guidelines for the management of non-specific low back pain in primary care

RELATED REPORTS

Upadacitinib is safe and effective for treatment of non-radiographic axial spondyloarthritis

Graded sensorimotor retraining may improve chronic lower back pain compared to sham procedure: The RESOLVE randomized clinical trial

#VisualAbstract: Sensorimotor retraining improves pain intensity in patients with chronic lower back pain

In-Depth [randomized controlled trial]: Participants were randomly assigned to one of three groups: paracetamol as needed (maximum 4000 mg/day, n=546), paracetamol at a regular dose (3990 mg/day, n=550) or placebo (n=547). The primary outcome was time in days until recovery from pain as defined by a 0 or 1 pain intensity measured on a 0-10 pain scale for 7 days. Secondary outcomes were pain intensity, disability, function, global rating of symptom change, sleep quality, and quality of life.

By 12 weeks, 466 (85%) participants in the regular group, 452 (83%) in the as-needed group, and 461 (84%) in the placebo group reached recovery. The median time to recovery was 17 days (95% Confidence Interval [CI] 14-19) in the regular group, 17 days (15-20) in the as needed group, and 16 days (14-20) in the placebo group (regular vs. placebo, Hazard ratio [HR] 0.99, 95% CI 0.87-1.14; as-needed vs. placebo, 1.05, 0.92-1.19; regular vs. as-needed, 1.05, 0.92-1.20). Time to recovery did not significantly differ between groups (p = 0.55), even when calculating for best-case and worst-case recovery. Participants in all groups reported decreased treatment adherence, decreasing from 3500 mg/day in week 1 to 2800 mg/day in week 2. The median number of tablets taken daily was 4.0 (Interquartile range [IQR] 1.5-5.7, 2660 mg/day) in the regular group, 1.9 (IQR 1.0-4.0, 1000 mg/day) in the as-needed group in week 1 with 1.0 (0.4-2.7, 500 mg/day) daily overall, and 4.0 (IQR 1.5-5.7) daily in the placebo group. Adverse events were similar in all groups, with 99 (18.5%) reported in the regular group, 99 (18.7%) in the as-needed group, and 98 (18.5%) in the placebo group.

Image: PD 

©2012-2014 2minutemedicine.com. All rights reserved. No works may be reproduced without expressed written consent from 2minutemedicine.com. Disclaimer: We present factual information directly from peer reviewed medical journals. No post should be construed as medical advice and is not intended as such by the authors, editors, staff or by 2minutemedicine.com. PLEASE SEE A HEALTHCARE PROVIDER IN YOUR AREA IF YOU SEEK MEDICAL ADVICE OF ANY SORT.  

Tags: back paintylenol
Previous Post

Adverse childhood exposures associated with poor health in adulthood [Pediatrics Classics Series]

Next Post

Paclitaxel-coated balloons may decrease bronchial stenosis in lung transplants

RelatedReports

Chronic Disease

Upadacitinib is safe and effective for treatment of non-radiographic axial spondyloarthritis

August 16, 2022
Patient Basics: Back Pain
Chronic Disease

Graded sensorimotor retraining may improve chronic lower back pain compared to sham procedure: The RESOLVE randomized clinical trial

August 12, 2022
#VisualAbstract: Sensorimotor retraining improves pain intensity in patients with chronic lower back pain
StudyGraphics

#VisualAbstract: Sensorimotor retraining improves pain intensity in patients with chronic lower back pain

August 12, 2022
The ABCD2 score: Risk of stroke after Transient Ischemic Attack (TIA) [Classics Series]
Radiology Classics

MRI reveals lumbar intervertebral disk herniations are common in asymptomatic individuals [Classics Series]

August 3, 2022
Next Post
Macitentan better than placebo for preventing progression of pulmonary arterial hypertension [SERAPHIN Trial]

Paclitaxel-coated balloons may decrease bronchial stenosis in lung transplants

Updated USPSTF guidelines favor treatment of mild gestational diabetes

Shift work linked to increased risk of diabetes

Of Background Image

Funding for antibiotic research in UK may be trailing behind resistance

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Momelotinib reduces symptom burden compared to danazol in patients with myelofibrosis
  • Machine renal perfusion reduces delayed graft function after transplantation
  • COVID-19 mRNA vaccines are safe and effective in children aged 5 to 11 years
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

Want more physician-written
medical news?

Join over 10 million yearly readers and numerous companies. For healthcare professionals
and the public.

Subscribe for free today!

Subscription options