Daffodil International University
Science & Information Technology => Science Discussion Forum => Life Science => Topic started by: russellmitu on July 24, 2014, 02:53:18 PM
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In a surprising finding, paracetamol, which has been the world's most recommended first-line pain killer for acute low-back pain, has been found to be no better than a dud.
Researchers will announce on Thursday in the world's leading medical journal The Lancet that paracetamol is no better than placebo at speeding recovery from acute episodes of lower back pain or improving pain levels, function, sleep or quality of life.
This is the first large randomised trial to compare the effectiveness of paracetamol with placebo for low-back pain and questions the universal endorsement of paracetamol as the first choice painkiller for low-back pain.
Lower back pain — a common phenomenon among Indians — has been found to be the leading cause of years lived with disability (YLD) globally.
The Global Disease Burden study showed that lower back pain caused 83.1 million YLDs across the globe in 2010.
National clinical guidelines universally recommend paracetamol as the first choice analgesic for acute low-back pain, despite the fact that no previous studies have provided robust evidence that it is effective in people with low-back pain.
The paracetamol for Low-Back Pain Study (PACE) randomly assigned 1652 individuals (average age 45 years) with acute low-back pain from 235 primary care centres in Sydney, to receive up to four weeks of paracetamol in regular doses (three times a day; equivalent to 3990 mg per day), paracetamol as needed (maximum 4000 mg per day), or placebo. All participants were followed-up for 3 months.
No differences in the number of days to recovery were found between the treatment groups—median time to recovery was 17 days in the regular paracetamol group, 17 days in the as needed paracetamol group, and 16 days in the placebo group. Paracetamol also had no effect on short-term pain levels, disability, function, sleep quality, or quality of life. The number of participants reporting adverse events was similar between the groups.
"Simple analgesics such as paracetamol might not be of primary importance in the management of acute lower back pain", said lead author Dr Christopher Williams from the George Institute for Global Health at the University of Sydney in Australia. "The results suggest we need to reconsider the universal recommendation to provide paracetamol as a first-line treatment for low-back pain, although understanding why paracetamol works for other pain states but not low-back pain would help direct future treatments".
He adds, "In view of the quick timeframe in which participants in our trial improved compared with other cohorts, it would be interesting to see whether advice and reassurance might be a more effective than pharmacological strategies for acute episodes of low-back pain".