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Updated: Mar 19, 2026

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Paracetamol for low back pain.

Bruno T Saragiotto1, Gustavo C Machado, Manuela L Ferreira

  • 1Musculoskeletal Division, The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, Australia.

The Cochrane Database of Systematic Reviews
|June 9, 2016
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Paracetamol (acetaminophen) offers no significant benefit over placebo for acute low back pain (LBP). Evidence for its effectiveness in chronic LBP is uncertain, with no notable improvements in pain, disability, or quality of life observed.

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Area of Science:

  • Pain Management
  • Pharmacology
  • Clinical Research

Background:

  • Low back pain (LBP) is commonly treated with analgesic medications.
  • Paracetamol (acetaminophen) is a frequently recommended first-line treatment for LBP.
  • However, its efficacy for LBP remains uncertain.

Purpose of the Study:

  • To systematically investigate the efficacy and safety of paracetamol for non-specific low back pain.
  • To evaluate paracetamol's impact on pain, disability, quality of life, and adverse effects.

Main Methods:

  • Conducted comprehensive searches across multiple databases up to August 2015.
  • Included randomized controlled trials comparing paracetamol with placebo for non-specific LBP.
  • Assessed risk of bias and evaluated evidence quality using the GRADE approach.

Main Results:

  • High-quality evidence shows no difference between paracetamol (4g/day) and placebo for acute LBP at various time points.
  • Paracetamol demonstrated no significant effect on quality of life, function, recovery, or sleep.
  • No significant differences were found in adverse events, adherence, or rescue medication use.

Conclusions:

  • Paracetamol does not yield superior outcomes compared to placebo for individuals with acute low back pain.
  • The effectiveness of paracetamol for chronic low back pain remains uncertain due to limited and low-quality evidence.