Tylenol (paracetamol) overpromises and under-delivers for back pain and other types of joint pain say The British Medical Journal

Tylenol (paracetamol) has been used for years for fever and joint pain, with back pain being one of the most common uses. According to a new paper in The British Medical Journal entitled “Efficacy and safety of paracetamol for spinal pain and osteoarthritis: systematic review and meta-analysis of randomised placebo controlled trials“, this once wonder drug may not be so wonderful.

Many people take Tylenol for chronic pain relief and often believe it helps. Apparently, some of the relief may be the Placebo effect, especially when it comes to lower back pain.

While most people with a bout of acute back pain may reach for a bottle as their first line of relief, medications’ effects on joint pain are purely symptomatic, especially with regards to lower back pain. Quite simply, mechanical problems require a mechanical solution and many people are now finding that a good chiropractor is likely the best choice and that a pain reliever is helpful in relieving the pain while they are seeking appropriate treatment.

Why see a chiropractor instead of treating the symptoms with a pill?

While a number of sources agree chiropractors should be the first type of care for acute lower back pain, most orthopedics still routinely refer to physical therapists, give a cocktail of anti-inflammatory medication and pain killers, and tend to unjustly shun chiropractors. The public, Consumer Reports, and most recently Bottom Line Personal have done their own research and found that chiropractors, spinal manipulation, and their management approach offer the fastest relief of acute and chronic lower back conditions including herniated discs as well as sciatic pain. Many chiropractors combine manipulation, myofascial release treatment, exercises as well as foot orthotics to effectively manage the mechanical reasons behind why your back is painful.

In certain areas of the country, some orthopedics do refer to chiropractors and are thrilled by the improvement in their patients, when compared to other methods they had routinely endorsed in the past. A number of chiropractors who had been to the Olympics and other international athletic events had found that once the orthopedic doctors worked side by side with them, they too became fans. One doctor had told me that in his state, the managed care plans were unsatisfied with the adoption of chiropractic referrals by orthopedics and actually require them to refer 30 percent of their lower back pain cases to chiropractors. The results were their costs went down, the results improved, there were fewer surgeries and MRI’s and patients were thrilled. Unfortunately, that has not yet happened where we are in NJ, however, cost reduction strategies for lower back pain treatment are likely to endorse chiropractors in the future.

Acute management of lower back pain can include medication, however, with the current new information that is available, it is likely today’s patients are more likely to use medications other than Tylenol due to effectiveness and consult chiropractors. More recently, The Annals of Internal Medicine in 2017 recommended that people should use movement-based treatments such as chiropractic, and medication or invasive procedures should be avoided.  While more physicians are following these recommendations, many still ignore these evidence-based guidelines.

You can read more about the recent information on Tylenol in the NY Times here here