For Lower Back Pain, You Can Skip the Tylenol


Here’s the latest from the frontiers of medical research:

About two-thirds of adults have lower back pain at some point in their lives, and most are told to take acetaminophen, sold under brand names like Tylenol, Anacin and Panadol. Medical guidelines around the world recommend acetaminophen as a first-line treatment.

But there has never been much research to support the recommendation, and now a large, rigorous trial has found that acetaminophen works no better than a placebo.

The good folks at Johnson & Johnson will no doubt disagree with extreme prejudice, but I’m not surprised. I suppose different people respond differently, but I’ve basically never responded other than minimally to Tylenol. It might dull a bit of headache pain slightly, but that’s about it. However, there’s more:

Dr. Williams said that acetaminophen had been shown to be effective for headache, toothache and pain after surgery, but the mechanism of back pain is different and poorly understood. Doctors should not initially recommend acetaminophen to patients with acute low back pain, he said.

Hey! That’s right. I had some mild toothache recently thanks to a filling that involved a fair amount of work beneath the gum line. It acted up whenever I chewed food on that side of my mouth, and I found that Tylenol made it go away within 20 minutes. I was pretty amazed, since Tylenol had never really worked for anything else. But it was great for toothache.

Anyway, everyone is different, and Tylenol might work for you better than it does for me. It might even work for back pain. It doesn’t on average, but that doesn’t mean it’s ineffective for everybody. In the meantime, maybe the medical research profession could hurry up a bit on that business of understanding what lower back pain is all about, OK? It so happens that I could use some answers on that score.

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