Paracetamol & Back Pain

Parcetamol & Back PainAs you may be aware, a recent study published in the Lancet, revealed paracetamol not to be to be effective in relieving back pain.

Obviously, this has resulted in a number of articles being published, highlighting the drugs ineffectiveness. Some of these articles have pointed out that roughly 80% of us will experience lower back pain at some point. They also explain that 50% of the people in the study were “better” within two weeks, regardless of whether they received paracetamol or not, and they encouraged those suffering from back pain to stay active.

Many of the patients consulting me for lower back pain, describe a common pattern. They have typically experienced several episodes of back pain, often over many years, with each episode being a little more severe. Often, pain that began in the lower back, has since spread to the buttock, thigh or lower leg and symptoms have persisted for longer periods. Previously, these patients were in the 50% group, getting better within two weeks.

What this pattern shows us is that lower back pain does often get “better” within two weeks, however, it is often recurrent. In fact, there is evidence to suggest that 40-50% of patients go on to develop recurrent lower back pain.

The recurrent nature of lower back pain is what we should be addressing and explaining to our patients. Having them resume normal activities, the same activities that possibly played a role in the onset of their back pain, may in fact play be linked to the recurrent nature of the problem. Those of us that have suffered lower back pain, myself included, know that there are certain movements and postures that aggravate our pain and possibly others that ease it. When in pain we naturally to avoid painful movements, however, we soon return to these previously painful movements once our pain is “better”. Just remember those movements were painful for a reason! Pain is a warning that something is wrong, just like your engine warning light.

There is certainly some truth in telling patients they will get “better” in a few weeks and to keep active, however, I believe that this message may be doing those who suffer back pain a disservice. Back pain is not a diagnosis, it’s a symptom with many causes. However, it is often recurrent because we continually subject our backs to sustained poor posture, slumping over the computer and performing everyday movements and exercisers with poor technique. These mechanical factors need to be addressed in those suffering from back pain and in my experience, when they are, lower back pain can typically be managed and it’s recurrence significantly reduced.