Acetaminophen Is Poor Choice for Pain Relief
Acetominophen, a pain reliever used in popular over-the-counter drugs such as Tylenol, is widely used by patients to control both acute and chronic pain.
But is it the best choice? After all, we have been aware of the drug's possible toxic effects on the liver for some time, when it is inappropriately overused. A recent meta-analysis has found that along with acetominophen's possible toxic effects, the drug is not even particularly effective in reducing pain intensity or disability or improving quality of life for patients with low back pain related to knee or hip osteoarthritis.
The study offers an opportunity for health care practitioners to counsel their patients on other more appropriate methods to control pain, particularly chronic pain, including methods such as low-level laser therapy. Many of these patients may already be coming to your practice, but imagine how many more patients could benefit from this drug-free and side effect-free treatment.
Acetaminophen is the most popular pain reliever in the U.S., accounting for an estimated 27 billion annual doses as of 2009.
With 100,000-plus hospital visits a year by users, it's also the most likely to be taken inappropriately. In fact, improper use, coupled with the drug's narrow safety margin, means "a large fraction of users [are] close to a toxic dose in the ordinary course of use," according to the Food and Drug Administration.
But for the sake of discussion, let's ignore the safety issues for a moment. Is acetaminophen an effective pain reliever in the first place? Not for low back pain and pain attributable to knee / hip osteoarthritis, conclude the authors of a recent meta-analysis. The just-published review of 13 randomized trials has yielded "high-quality evidence" that paracetamol (acetaminophen) does not reduce pain intensity or disability, and does not improve quality of life, in the short term for people experiencing LBP; and provides only "minimal, short-term benefit" for people suffering from hip or knee pain caused by OA, stating that "the small effects ... are not likely to be meaningful for clinicians or patients."
This article excerpt, by Peter W. Crownfield, Executive Editor of Dynamic Chiropractic, originally appeared here: www.dynamicchiropractic.com/mpacms/dc/article.php?id=57383.
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