Medication Dangerous & Not Helpful for Lower Back Pain

Do you take medication for back, knee, or hip pain?  If you are like most people, you do.  Why?  Well, probably because it works, or at least, the commercials tell us it does.   And they couldn’t say that if it were not true, right?

Acetaminophen is the most common drug ingredient in America. It is found in more than 600 different over-the-counter and prescription medicines, including generic and store brand pain relievers, fever reducers, and sleep aids as well as cough, cold, and allergy medicines.

Here is a partial list of some of the more common medications with acetaminophen in it:

Here is a more complete list:  http://www.knowyourdose.org/common-medications

Oh, by the way, the new study uses the medication name “paracetamol” as the fancy name for acetaminophen.

So, what did this new research tell us?

Short version:

A research study that reviewed recent research of only placebo studies for acetaminophen found that it is ineffective for low back pain and barely helpful for hip or knee pain of osteoarthritis. Also, the evidence is very clear that taking acetaminophen/Tylenol makes one nearly 4x more likely to have abnormal results on liver your function tests.”

Fact-filled version:

The study notes:

“Prescription of drugs is the most common approach to treatment used by general practitioners for spinal pain and osteoarthritis,6 and guidelines consistently recommend the prescription of paracetamol (acetaminophen) as the first line analgesic for these conditions.7891011”

Despite Tylenol/Acetaminophen being the most common (and most officially appropriate) recommendation for lower back pain, hip, and knee arthritis, this study’s authors conclude that it “is ineffective in the treatment of low back pain and provides minimal short term benefit for people with osteoarthritis. ”

Also, the data in this research review, they stated:  “‘High quality’ evidence showed that patients taking paracetamol are nearly four times more likely to have abnormal results on liver function tests.”  To be clear, that doesn’t necessarily mean liver damage, but it sure seems to indicate liver stress.

I find this rather shocking.  The most commonly recommended medication and the official “first-line”approach is shown to be ineffective.  You can use this information to blame people and make judgments, but I don’t think that is helpful.  Instead, don’t be afraid to be your own advocate when it comes to health decisions.  We doctors don’t really know as much as we think we do.   A doctor’s “practice” includes interacting and learning from the response of the patient.

And,  “First do no harm.”  This is why I like to use natural approaches.   It doesn’t always work, but supporting the body’s natural healing potential is generally much safer than manipulating the biochemistry or removing body parts, when you have  the option.

Oh another interesting aside, researchers must disclose any possible conflicts of interest that might skew their conclusions. For this study, “Four of the coauthors received research support from GlaxoSmithKline.”  Of course, Glaxo (GSK) is a massive medication manufacturer, which makes drugs with Tylenol/acetaminophen in it.  So, I applaud the authors for making such a bold conclusion, even though they get part of their paycheck from the manufacturer of some of these medications.

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For more information on how we deal with lower back pain, whether it be a little strain or a herniated disc pressing on a nerve, click on over to our Back Pain page.

You might also be interested in reading about a patient who had lower back pain and infertility.

References:

1. Efficacy and safety of paracetamol for spinal pain and osteoarthritis: systematic review and meta-analysis of randomized placebo controlled trials. British Medical Journal 2015; 350 bmj.h1225 (Published 31 March 2015) http://www.bmj.com/content/350/bmj.h1225