People with non-specific LBP should not be offered paracetamol alone for pain management.
Machado, G.C., Maher, C.G., Ferreira, P.H., Pinheiro, M.B., Lin, C.W.C., Day, R.O., McLachlan, A.J. and Ferreira, M.L., 2015. Efficacy and safety of paracetamol for spinal pain and osteoarthritis: systematic review and meta-analysis of randomised placebo controlled trials. BMJ, 350, p.h1225.
NICE 2016. Low back pain and sciatica in over 16s: assessment and management. NICE Guideline [NG59] November 2016. Available at: https://www.nice.org.uk/guidance/NG59
Do not offer paracetamol alone for managing low back pain.
NHMRC Australian Acute Musculoskeletal Pain Guidelines Group 2003. Evidence-based Management of Acute Musculoskeletal Pain. Available at: https://www.nhmrc.gov.au/
There are no randomised controlled trials assessing the effectiveness of simple analgesics in acute low back pain.
NO LEVEL I or II EVIDENCE
There is insufficient evidence for the effectiveness of simple analgesics versus NSAIDs in acute low back pain.
Paracetamol is less effective than heat wrap therapy in acute low back pain.
There is insufficient evidence for the effect of paracetamol compared to electro-acupuncture in mixed populations with low back pain.
Stochkendahl MJ, Kjaer P, Hartvigsen J, Kongsted A, Aaboe J, Andersen M etal. National Clinical Guidelines for non-surgical treatment of patients with recent onset low back pain or lumbar radiculopathy. Eur Spine J. 2017 Apr 20. doi: 10.1007/s00586-017-5099-2. [Epub ahead of print]
Do only offer patients with recent onset LBP paracetamol in addition to usual care after careful consideration, as the evidence points towards no short-term effect