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Harvard Health Blog
When back pain strikes, all you want is relief—as quickly as possible. Many folks turn to over-the-counter pain relievers to help take the edge off and keep them moving. Acetaminophen and non-steroidal anti-inflammatory drugs, or NSAIDs (ibuprofen, naproxen, aspirin), are common and reasonable choices.
Australian researchers set out to see just how helpful acetaminophen is for people with back pain that comes on suddenly (so-called acute back pain). They wanted to know if acetaminophen shortened the time from the start of back pain to complete relief—meaning a pain rating of 0 or 1 (on a scale from 0 to 10, with 10 being the worst) for at least 7 days.
What they found was a bit surprising.
For people who used acetaminophen only when their back pain bothered them, it took about 17 days to get complete relief. For those who took the medication three times a day, it also took about 17 days for full relief. And for those who took a placebo—a sugar pill with no medicine at all—the time to recovery was 16 days. In other words, in this group of volunteers the medication made no difference in how fast back pain went away and stayed away. The researchers also found that all three groups had similar experiences in terms of the severity of their pain, disability, and function. Their findings were published online yesterday in The Lancet.
Does this mean that you shouldn’t bother to use acetaminophen for back pain? Not necessarily. It may work well for some people. And, the alternatives may be worse. Some people should steer clear of NSAIDs. They can irritate the digestive tract and increase bleeding risk among people who take drugs that reduce blood clotting. Muscle relaxants tend to be sedating.
But acetaminophen isn’t without risks and side effects. Taking too much acetaminophen can seriously damage the liver, sometimes leading to liver failure or death. Ideally, the average healthy adult shouldn’t take more than 3,000 milligrams a day. Because combination cold, headache, and sleep products contain acetaminophen, you need to pay careful attention.
Back pain is tricky. Acute back pain may follow something you did at work or at play. It can also be caused by a pinched nerve or a degenerative condition such as arthritis. For one-third of people with acute low back pain, discomfort greatly improves in as little as one week.
Here are some tips for trying to get through the worst of your back pain without medication:
Most back pain isn’t dangerous, but it is important to know “red flag” situations that require immediate medical attention. “Be sure to see your doctor right away if you have unexplained back pain with fever, weight loss, or neurological symptoms such as numbness, weakness, or incontinence,” says Dr. Robert Shmerling, clinical chief of rheumatology at Beth Israel Deaconess Medical Center and associate professor in medicine at Harvard Medical School.
Nancy Ferrari, Editor in Chief, Harvard Health Publishing
As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles.
No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
A bird flu primer: What to know and do
New urine test may help some men with elevated PSA avoid biopsy
Dupuytren’s contracture of the hand
Why play? Early games build bonds and brain
Moving from couch to 5K
How — and why — to fit more fiber and fermented food into your meals
Tick season is expanding: Protect yourself against Lyme disease
What? Another medical form to fill out?
How do trees and green spaces enhance our health?
A muscle-building obsession in boys: What to know and do
Pain
Pain
Pain
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