Tylenol No Good For Back Pain or Osteoarthritis

In a recent blog, we reported on a double-blind study that found that acetaminophen (Tylenol), the most recommended drug for back pain, was no more effective than a placebo for treating back pain (Lancet 2014;doi:10.1016/S0140-6736(14)60805-9). Now, a meta-analysis has confirmed this result and delivered even worse news for Tylenol. . . .

Researchers conducted a systematic review and meta-analysis of thirteen controlled studies that compared acetaminophen to placebo for back pain or osteoarthritis.

They found that, despite the fact that Tylenol is the first line painkiller recommended by doctors for back pain, there was, in fact, “high quality” evidence that it is ineffective for reducing pain, for reducing disability or for improving quality of life.

For osteoarthritis, the results were little better. There was “high quality” evidence that there was a statistically significant, but not clinically important, effet on pain and disability.

What’s worse than Tylenol not helping back pain or osteoarthritis is that it did harm. There was “high quality” evidence that people taking acetaminophen are more than four times more likely to have abnormal results on liver function tests.

BMJ 2015;350:h1225