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Acetaminophen For Back Pain? A Study Says No, But Doctors Still Recommend It


Tylenol and other products containing acetaminophen are prescribed often for pain relief. But there’s been ongoing debate about whether it does anything for lower back pain. A recent study published in the British Medical Journal says no.

In our consumer health series, Vital Signs,   Dr. John Stavrakos, a physical medicine and rehab specialist with Texas Health Arlington Memorial, said the reason may stem from the structure of the back itself.

Highlights from the interview with Dr. Stavrakos:

Why acetaminophen may not be effective on acute lower back pain: “The back is complicated. It is a series of multiple joints. It holds up you entire upper body, and it has lots of structures than can cause pain. (Acetaminophen may affect one joint, but not others at the same time?) When someone with back pain says ‘I went to the doctor.” Well, did you see a neurologist, a gastroenterologist? There are so many things in the back that can cause pain.

Why continue to prescribe acetaminophen (Tylenol) over other choices: “When you look at some of the other options: Aleve or Ibuprofen, or the NSAIDS – the non-steroidals – they can have pain relief. However, they can increase a bleeding risk. They can cause ulcers. So Tylenol is seen as very simple, over the counter, inexpensive and in small doses, most people don’t suffer problems. Good first place to start.”

Stavrakos’ approach to treating back pain: “Get to know the patient. His lifestyle, hobbies. Is this someone you need to motivate to work harder? Someone you need to reign back in – ‘you’re doing too much.’  They try the least invasive approach first – the fewest meds, fewest injections. Often with many people it’s a matter of rest, a low dose of medicine, heat, stretching, maybe some physical therapy and if things aren’t getting better, bump up the ante if you have to. And their other modalities if needed: Acupuncture works for some people. Prolotheraphy, where you strengthen up the ligaments in the back. In extreme cases, there can be surgery.

To prevent back pain: Good back mechanics – lift with your legs, try to keep your back straight. Maintain an appropriate weight. Work on stretching (daily) of the back and legs. Keeping your core muscles (lower abdominals, muscles on your side, obliques, lower back muscles) is huge.

For more information:

More on the study 

10 Ways to Manage Low Back Pain at Home

Back Pain Do's and Don'ts 

Sam Baker is KERA's senior editor and local host for Morning Edition. The native of Beaumont, Texas, also edits and produces radio commentaries and Vital Signs, a series that's part of the station's Breakthroughs initiative. He also was the longtime host of KERA 13’s Emmy Award-winning public affairs program On the Record. He also won an Emmy in 2008 for KERA’s Sharing the Power: A Voter’s Voice Special, and has earned honors from the Associated Press and the Public Radio News Directors Inc.