El Reg reports:
Reported in The Lancet, the study [on paracetamol also known as acetaminophen] funded by the National Health and Medical Research Council of Australia and pharmaceutical company GlaxoSmithKline Australia ran for over three years and involved "a multicentre, double-dummy, randomised, placebo controlled trial across 235 primary care centres in Sydney."
The study saw some patients given regular doses paracetamol, others told to take the drug when in pain and a third group handed placebos. Those given paracetamol, in either mode, reported no less pain than those taking placebos. Nor did sugar-pill-poppers recover from their ailments more slowly.
The authors therefore "question the universal endorsement of paracetamol in this patient group."
In this interview the study's leader Professor Chris Maher even questions whether Paracetamol can be considered a pain-killer.
"The jury is out" on whether the drug lessens pain, Professor Maher says about two minutes into the interview.
So, what does work? Don't just lay there; for starters, get up and MOVE AROUND.
(Score: 1, Insightful) by Anonymous Coward on Friday July 25 2014, @12:49PM
Terrible for the liver, especially if one is not careful with the maximum daily dosage of 4000mg.
I highly rate pregabalin (Lyrica) as a general painkiller and for nerve pain and muscle relaxation in specific. Much less habit-forming and with less rebound than the opiate painkillers, less risky than even the lighter opioids like codeine or the dodgy-but-oft-prescribed Tramadol in my experience.
(Score: 2) by Dunbal on Friday July 25 2014, @01:05PM
Problem with Lyrica is it can increase your appetite and affect your moods.
(Score: 2, Interesting) by Anonymous Coward on Friday July 25 2014, @01:12PM
Lyrica less habit-forming? Oh please. I have been on it for few months now and I can't be without it even for few days without having severe withdrawals. And this is coming from a person who has been on opioids (codeine) for a longer time and still have no dependency on it and on paracetamol and ibuprofen even longer without any problems. Anecdotal, yes, but all the MD's that I've discussed the medicine about agree that it causes severe dependency in people and is the leading legal drug that leads people to rehab clinics in Finland.
-EPIH
(Score: 3, Interesting) by LaminatorX on Friday July 25 2014, @01:05PM
I've had back trouble off and on since a nasty fall some years ago. My legs healed asymmetrically, so my stride is constantly trying to make my spine lean to one side. When I get into trouble, I take ibuprophin for the pain, alternate between resting with ice-packs and gentle activity, and see a chiropractor (a good one who shares a practice with an orthopedist and a physical therapist)to straighten my spine back out as the icing brings the inflamed disk back down to size.
I avoid heat on the affected area. It feels good in the moment, but increases swelling which adds more pressure to the inflamed area.
I obviously haven't done a double blind test on this, but I have had success.
(Score: 2) by randmcnatt on Friday July 25 2014, @01:49PM
I take ibuprofen in the morning, acetaminophen in the afternoon, and ibuprofen in the evening, have for years, and probably will for life (as an alternative to opiates). The acetaminophen is no better as a pain killer than it ever has been, but it still helps for the usual 4 to 6 hours.
The Wright brothers were not the first to fly: they were the first to land.
(Score: 0) by Anonymous Coward on Friday July 25 2014, @02:28PM
From the summary Those given paracetamol, in either mode, reported no less pain than those taking placebos.
This is a real problem with 99.999% of our drug tests too. They all test against placebos. Not against the current best. Placebos is where you start. But rarely do they go past that.
(Score: 1) by dcollins on Friday July 25 2014, @08:12PM
That's about the most multiply-stupid thing you could say on the subject. If two different medications are in question, then you can just compare the numbers from two different studies. (In terms of wellness reporting, days sick/out of work, etc.) The placebo is only there to serve as a baseline in the control group, because you can't trust people's opinions when they're not popping pills and thinking they're being non-treated.
(Score: 2) by sjames on Friday July 25 2014, @10:06PM
Yes, it is. Too bad that's the FDA criterion for approval. Literally, they just have to show that it probably won't kill you and it's probably better than nothing. Note that this means there are cases where the drug may actually be inferior to snake oil.
(Score: 2) by hemocyanin on Friday July 25 2014, @03:52PM
Ibuprofen.
I had a root canal a decade ago. I had expected something fun like the percocet or percodan I had gotten 10 years before that when I had my wisdom teeth extracted. Instead I got a prescription for 600mg Motrin every four hours. I tossed the scrip and bought a bottle of generic Ibuprofen (200 mg) and took three at once on the suggested schedule. I had absolutely no pain at all. It was wild and made me a total believer in Ibuprofen.
You can take something like 3200mg of ibuprofen per day, though if you did that for a long time you'd end up with an ulcer. http://www.drugs.com/dosage/ibuprofen.html [drugs.com]
When I tweak my back or my neck, as soon as I notice it, I'll take three generic ibuprofen, do some stretching, if I'm home I'll use my substantial massager for ten or fifteen minutes (like this one: http://www.google.com/search?q=Thumper+Sport+Percussive+Massager [google.com] ), use ice if I can (e.g., at home), and repeat 2 or 3 times over the next 12-16 hours. That usually does the trick so well I feel fine the next day or day after.
(Score: 2) by hemocyanin on Friday July 25 2014, @03:54PM
Lame self-reply, I should note, I'm not a doctor.
(Score: 2) by Blackmoore on Friday July 25 2014, @06:17PM
Well I was taking so much ibuprofen per day my doctor told me to stop. his choice? yeah - this garbage.
I decided alcohol was a better pain reliever.
(Score: 2) by frojack on Friday July 25 2014, @11:28PM
Agreed, 600mg is a prescription dose, and you really don't feel any pain, and no side effects. I've had separated shoulder, dislocation, and even broken bones in the mid-arch (forget their weird names), and it has worked wonders.
I've been advised not to use it for long duration. (for some values of long).
(Don't let them prescribe those Volkswagen sized 600mg tabs, just buy the 200s.)
No, you are mistaken. I've always had this sig.
(Score: 1) by pendorbound on Friday July 25 2014, @02:34PM
IANADoctor, but in my personal experience back pain is usually caused by (or at least associated with) inflammation. Acetaminophen (sorry, I'm a Yank...) doesn't do nearly as much as NSAIDs for inflammation. "Non-steroidal anti-inflammatory drug" -- go figure... Ibuprofen or naproxen sodium (or even good old aspirin) do a much better job for me, I suspect because they actually address the problem (inflamed tissues) rather than trying to cover up the pain nerve impulses.
Granted you're trading liver damage for stomach lining damage, but at least your back doesn't hurt as much, and you can drink more...
(Score: 0) by Anonymous Coward on Friday July 25 2014, @10:36PM
good old aspirin) do[es] a much better job for me
WFM too. When I had a dental procedure years and years ago, Tylenol was recommended.
(Aspirin has anti-coagulant properties.)
That was the only reason I would ever have used anything other than the $0.3c/pill treatment.
I injured my back at age 26.
My occasional pain used to be severe enough that I couldn't lift more that ~8 pounds without shooting pain.
I used to think that bed rest was the proper tack.
Now, whenever I feel back pain *starting*, I do some crunches.
Haven't had serious problems in many many years.
My use of pills is way down too.
-- gewg_
(Score: 0) by Anonymous Coward on Friday July 25 2014, @03:12PM
btw, paracetamol is acetaminophen, aka Tylenol.
Ibuprofen works pretty well for me. When it was available, Vioxx worked great, but apparently it was giving at-risk people heart trouble/attacks. The above commenter is correct, Ibp is also an anti-inflammatory, so it hits back pain from that angle as well.
Even a little acetaminophen overdose can kill you [thisamericanlife.org], so be very careful, and don't take even a little over the max dosage. Also I would check with a doctor before taking both Ibp and acetaminophen in the same day, as one commenter above is doing.
When my back pain was so severe that I tried a chiropractor, it actually did help. But maybe that was just the electrotherapy. ymmv
(Score: 2) by hemocyanin on Friday July 25 2014, @04:00PM
What's disconcerting about acetaminophen is that the dangers have been know for such a long time but it is only now that they are really being publicized. I remember back in my freshman year of college (1987), learning in either organic chemistry or bio, that the lethal dose of acetaminophen is very close to the effective dose.
(Score: 0) by Anonymous Coward on Friday July 25 2014, @05:51PM
Why do hospitals and doctors seem to push it so much then? I would never buy tylenol.
(Score: 1, Insightful) by Anonymous Coward on Friday July 25 2014, @04:11PM
A friend of mine has severe back problems due to injuries sustained while working for the police department, to the point where he was projected to be unable to stand up ever again. He's tried various pills, none of which seem to really work.
However, for him marijuana does an excellent job of reducing his pain to the point where he's up and about, able to work on small-scale projects and raise his kids. If only it were legal for him to do what works.
(Score: 2) by LoRdTAW on Friday July 25 2014, @04:27PM
I have a friend who inherited a spinal problem where he had severe herniated or ruptured discs (I forget). His father has two fused vertebrae and underwent surgery. Both he and his sister have both had major back surgery and fused vertebrae.
He still gets recurring back pain after any moderately strenuous lifting activity. He was put on prescription opioids but they either knock him out or make him vomit. His solution? Smoking pot. It does not numb the pain but it helps him deal with it. If his backs acts up and he is laid up in bed for the day he smokes a bowl. It enables him to get up and move around which helps relieve the pain. So he walks the dog, does chores that does not involve lifting or cooks dinner for his wife. This happens to him once or twice a month.
(Score: 2) by kaszz on Friday July 25 2014, @05:18PM
Aha.. new medication about to be promoted when paracetamol has left a market vacuum.
(Score: 2) by evilviper on Friday July 25 2014, @09:17PM
Aspirin and Ibuprofen work extremely well on both physical pain and headaches... Add some caffeine to the aspirin for bad headaches/migraines, and you're golden. Aspirin also has the added bonus of reducing swelling, clearing arteries and reducing the risk of heart attack, but similarly shouldn't be taken when you've got major open wounds, as it'll reduce clotting.
I've got a test lab in my old man with back and joint problems. "Tylenol" is a bad word in his house. It never helps one little bit when he needs it, where aspirin works great. And that's even when he's been prescribed huge doses of the stuff. 70 years of experience with pain pills, he's had plenty of time to evaluate them, and when in real pain the placebo effect is close to nil.
Aleve / Naproxen isn't as useless as Tylenol, but doesn't seem to work as well as the above, and it gives me pause just because of how very deadly it is to pets even in small doses.
Hydrogen cyanide is a delicious and necessary part of the human diet.
(Score: 2) by frojack on Friday July 25 2014, @11:33PM
I've heard it said that if Aspirin were invented today, no country would allow it on the market due to safety concerns.
Except that it is so damned effective for so many different things. (And probably safer too).
No, you are mistaken. I've always had this sig.
(Score: 2) by evilviper on Saturday July 26 2014, @04:30AM
That doesn't make any sense. It's one of the safest painkiller and NSAID-type drugs out there. Vastly safer than Tylenol. There's the risk of bleeding from excessive use, and a small chance of Reyes, but little else to be concerned with.
Hydrogen cyanide is a delicious and necessary part of the human diet.
(Score: 2) by frojack on Saturday July 26 2014, @06:05AM
May not make any sense, but still, that claim is out there:
http://www.medicalprogresstoday.com/spotlight/spotlight_indarchive.php?id=1039 [medicalprogresstoday.com]
http://www.theatlantic.com/magazine/archive/2010/07/no-refills/308133/ [theatlantic.com]
About the only time the FDA did vote on Aspirin they voted no.
http://www.medscape.com/viewarticle/785037 [medscape.com]
Aspirin never had to undergo FDA approval.
No, you are mistaken. I've always had this sig.
(Score: 3, Interesting) by evilviper on Saturday July 26 2014, @06:53AM
First link says drug companies would have developed Aspirin into more-specific drugs, and its current form would never have been up for approval by the FDA, he doesn't say the FDA would reject it.
Second link talks about how specific animals used for testing are more prone to side effects from aspirin than people, and MAY have failed there, instead of going further. It's also an extremely biased and slanted piece, doing mindless FDA-bashing.
Third link is paywalled for me, but I found another source which explains the rejection as:
"the data was simply insufficient to measure any reduction in fatal heart attacks. Hence, the panel members - while several expressed the sentiment that aspirin clearly is beneficial - voted "no" to Bayer's petition." http://heartdisease.about.com/cs/heartfailure/a/FDAaspirin.htm [about.com]
Hydrogen cyanide is a delicious and necessary part of the human diet.