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Research questions efficacy and safety of paracetamol for spinal pain and osteoarthritis

Australian researchers, published in the British Medical Journal this week, have found that paracetamol is ineffective in reducing pain and disability or improving quality of life in patients with low back pain. They also found that paracetamol offers a small but not clinically important benefit in reducing pain and disability in patients with hip or knee osteoarthritis. 

Machado and colleagues conducted a systematic review and meta-analysis from 13 randomised control trials. They also found that, while adverse events were reported at a similar level to that seen with placebo, patients taking paracetamol were nearly four times more likely to have abnormal results on liver function tests. 

These findings give cause to reassess the use of paracetamol as the first choice analgesic in managing osteoarthritis and spinal pain. The authors say that their results provide an argument to reconsider the endorsement of paracetamol in clinical practice guidelines for low back pain and hip or knee osteoarthritis.

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