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Acetaminophen may not relieve back pain
July 24th, 2014
02:07 PM ET

Acetaminophen may not relieve back pain

Doctors often suggest taking acetaminophen for low back pain relief. But according to a new study, the popular painkiller isn’t any more effective in alleviating an aching back than letting the pain naturally subside.

A study published Thursday in The Lancet found patients who took acetaminophen for low back pain had the same recovery time as those who took a placebo, or sugar pill. The study was partially funded by GlaxoSmithKline, a company that manufactures drugs containing acetaminophen.

Researchers in Australia looked at 1,643 patients with acute low back pain. Each was assigned to a different group for the experiment. The first group of 550 patients took six 665-milligram tablets of acetaminophen a day as well as one to two placebo tablets.

A second group of 546 patients took six placebo tablets a day and one to two 500-milligram tablets of acetaminophen as needed. The third group took all placebos.

The study authors found no difference in recovery time across all three groups, suggesting that acetaminophen is an ineffective treatment for low back pain.

According to the National Institutes of Health, low back pain is the most common cause of job-related disability. Currently, the NIH recommends that people experiencing low back pain take over-the-counter pain relievers such as acetaminophen or ibuprofen. The NIH also advises these patients to stop normal physical activity and apply heat or ice to the affected area.

Despite the results of the study, scientists caution that acetaminophen as a low back pain treatment shouldn’t be dismissed until further research is conducted. Since the painkiller is effective for treating toothaches and pain after surgery, the study authors write that further research is needed to understand why acetaminophen wasn’t effective in treating the study participants' pain.

Previous studies comparing ibuprofen and acetaminophen suggest neither is more beneficial in treating low back pain.


soundoff (68 Responses)
  1. portlandtony

    The study at one point talks about curing a lower back pain. i don't think acetaminophen or any mild analgesic is going to cure anything. They are used to lessen the symptoms until the body heals itself.

    July 24, 2014 at 14:30 | Report abuse | Reply
    • Sweety

      None of the analgesic help to cure the pain. These are meant to temporarily numb down the pain till body get time to heal itself.
      See below
      The study authors found no difference in recovery time across all three groups, suggesting that acetaminophen is an ineffective treatment for low back pain.

      The body is always going to take same amount of time to heal though you take acetaminophen or not. This study interprets Totally wrong conclusion

      July 24, 2014 at 16:11 | Report abuse |
    • Marrion

      I clicked on the study but found nothing in it that talks about a "cure" for low back pain. No pain killer can CURE low back pain. The low back pain is due to a structural or muscular problem. Most often resting the back will relieve the pain, but does nothing for the cause of the pain. If you strain your back again you will have the pain again. The source of low back pain is very elusive and is not easily diagnosed. Pain can be referred from one area of the back to another, and it is very difficult to determine where the pain originates from, even with MRI images. An MRI will show if something is torn, compressed, inflamed, or damaged due to arthritis, or other structural damage. Strained muscles will show a signal intensity of one degree or another, but nothing "cures" that.....you can only get temporary relief from pain killers, or steroid shots to the effected area, but exercising the muscles to strengthen them is the only "cure". Chiropractic can accomplish relief from pain by adjusting the back so that the compression of a nerve or muscle will be relieved, but if you do not exercise those muscles back to full strength you are wasting your time going to a chiropractor. I have been dealing with lower back pain all my life. You must recognize your limitations and not "do too much", or you are back at square one again. Acetominiphen and ibuprophen should relieve inflammation for a short while, but if a nerve or muscle is being compressed in the spine, you may need surgery, which in itself is hit or miss.

      July 25, 2014 at 09:22 | Report abuse |
    • Jojo

      I had back pain and still do from a kidney transplant. I find taking 1000 mgs of ES Tylenol is only good for about an hour. I've tried getting off the Oxycodone, but Tylenol does nothing to aleviate the pain for hours. I'm on 30 mgs of Oxy per day and some days that doesn't work some days. I don't do needles and don't want the "experts" messing with my spinal chord.

      July 26, 2014 at 12:25 | Report abuse |
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      August 13, 2014 at 09:58 | Report abuse |
  2. Jim

    What about Doan's Pills?

    July 24, 2014 at 15:26 | Report abuse | Reply
    • Marrion

      Wikipedia:
      Magnesium salicylate is a common analgesic and non-steroidal anti-inflammatory drug (NSAID) used to treat mild to moderate muscular pain. It is also used to treat headaches, general back pain, and certain joint pains like arthritis.

      It is found in a variety of over-the-counter(OTC) medications as an anti-inflammatory, primarily for back-pain relief. Magnesium salicylate can be an effective OTC alternative to prescription NSAIDs, with both anti-inflammatory and pain-relieving effects.

      Controversy
      While magnesium salicylate is an alternative for pain relief, it still is an NSAID like others in its category and can cause stomach ulcers, without any proven superiority over other over-the-counter type pain relievers (NSAID).

      Doan's specifically, and the company producing it, Novartis, have been tried over their claim that the product is superior in providing pain relief. In June 1996, the FTC (Federal Trade Commission) charged the company with violating federal law with its unsubstantiated claim.[1] In March 1998, the court ruled in favor of the FTC, but there was no stipulation about how the company should or would have to mend its advertising/packaging. Thus, Doan's was able to continue marketing as a "superior treatment for back pain".

      July 25, 2014 at 09:35 | Report abuse |
  3. debbie

    I had a thumb joint reconstruction 3 months ago, still hurts and nothing I've taken has helped, so I just don't take anything. Pain after surgery was terrible, hydrocodone/apap (Tylenol) didn't even touch it. I think when nerves are involved it's hard to get pain relief from anything

    July 24, 2014 at 16:27 | Report abuse | Reply
    • ivan

      Debbie,
      You are correct, nerve pain is not relieved by analgesics even the ones that contain codeine! But there are special formulae out there that do the trick and they are only availabel by a doctor prescription and by really a specialized dr not just your GP. If you ar desperate then an injection at the root of the nerve will calm down the nerve. Talking from a guy whos been through it for over 40 years!

      July 24, 2014 at 19:28 | Report abuse |
    • Marion

      Generic name: Hydrocodone/APAP (multiple manufacturers)
      Common U.S. brand names: Lortab (UCB Pharma), Vicodin (Abbott Laboratories)
      Popularity: First most commonly prescribed drug between 2002-2007 (U.S.)
      Class: Analgesic combination, narcotic

      Hydrocodone Apap is NOT TYLENOL. It is a narcotic, and is very addictive.

      July 25, 2014 at 09:40 | Report abuse |
    • Marion

      Ivan.....what "special formulae" are you talking about? Any doctor, willing to prescribe it, can subscribe it. A GP probably will send you to a pain management doctor who may or may not prescribe a "special formulae", which is nothing but a stronger dose.

      July 25, 2014 at 09:44 | Report abuse |
    • Farrok

      Get a Green Card for Medical Marijuana then ask your physician for Celebrex take a capsule of Celebrex and wait 1 to 1 1/2 hours and smoke some Medical Marijuana. Personally I find this combination better than a shot of Morphine at a hospital emergency room for back pain and I have had many visits to an emergency room for back pain.

      I don't know what the interaction is between the two is, but the pain relief is Better than Morphine for pain. This is the voice of experience as I am no a physician nor a bio chemist all I know is that it Works as has more wallop than Morphine for pain relief.

      July 25, 2014 at 13:01 | Report abuse |
    • sara

      Neurontin is something to try non addictive and for sure helps with nerve pain!

      July 26, 2014 at 20:28 | Report abuse |
    • Absynthe J

      I've been on Hydrocodone APAP for 10 yrs. I've not been pleased w/tylenol in my painkillers. Also none too pleased w/docs giving me too many meds that nearly killed me in public, 2 yrs ago. Shingles on top of chronic pain is one of the WORST pains I can think of! 2 Painkillers + Valium or something like it, nearly killed me, when the culprit was SHINGLES. I'd been told, nothing could be done.

      Unmanaged Chronic pain is a NIGHTMARE. I can't work, can barely do anything, each & every day due to PAIN that rarely goes away. Docs try, but Parkinson's drug for leg pain causes me to fall asleep too much. I'm EXHAUSTED from fighting pain, from 4AM – 7AM already in the morning. It's usually at an 8/10. Nurse started to write it was tolerable. I told her, she's smoking something, because I was out of my mind in AGONY.

      Only way my own mind fights the pain, is to DISTRACT me. I NEED TO WORK. Yet I'm given junk meds, because of FEAR. YET men are given what works on me. I'd like to be awake more than 8 hrs per day, because Norco/Tylenol mix DOES NOT WORK, over LAST TEN YEARS.

      August 25, 2014 at 23:54 | Report abuse |
  4. luke

    "The study authors found no difference in recovery time across all three groups, suggesting that acetaminophen is an ineffective treatment for low back pain."
    Confused. How are recovery times and pain associated? Pain is a perception and recovery is physically healing. I can break my nose, and no pill will help me heal faster, so I'm not sure why they expected acetaminophen to help. A pill however can make the recovery more pleasant, by relieving the pain of the physical damage that has to heal.

    July 24, 2014 at 16:30 | Report abuse | Reply
    • P

      I hurt my back recently and the pills helped me to keep moving and keep up with my activities. It didn't heal me faster but allowed me to be more active rather than loosing strength entirely.

      July 25, 2014 at 01:52 | Report abuse |
    • Marion

      P wrote this: I hurt my back recently and the pills helped me to keep moving and keep up with my activities. It didn't heal me faster but allowed me to be more active rather than loosing strength entirely.

      all the pills did was relieve the pain temporarily, but did nothing to "strengthen" the muscles. Only exercise will accomplish "strengthening of muscles". If you were relieved of pain, and continue your normal activities, you were only weakening the muscles more. There is no short cut to this......it is hard work, over long periods of time, to strengthen the muscles around and to the source of the pain. Resuming normal activities because you are temporarily free of pain, is an illusion.

      July 25, 2014 at 09:50 | Report abuse |
  5. pogostick

    Sometimes lower back pain is caused by a worn out mattress, weak stomach muscles, a beer belly, large breasts in females etc. Acetaminophen is only going to give temporary relief. Swallowing acetaminophen every day stresses your kidneys.

    July 24, 2014 at 17:08 | Report abuse | Reply
    • Marion

      Correct......but not just the kidneys. These NSAIDS can can cause gastro-intestinal bleeding, gastritis, ulcers, and even precede cancer of the stomach. Always use buffered otc NSAIDS, but that only protects you from stomach pain and fools you into thinking it is causing no damage to your stomach. You can be taking these buffered products over time and not even know the damage it is doing to your stomach lining as you won't feel the stomach pain. I cannot take prescription NSAIDS because they are not buffered, and I immediately get stomach pain from them. I take them only on a extreme "as needed" basis.

      July 25, 2014 at 09:57 | Report abuse |
    • GI Joe

      Acetamenaphine goes thru the LIVER. It can cause liver damage. Tylenol goes thru the Kidneys.

      July 25, 2014 at 14:21 | Report abuse |
    • tartofdarkness

      Acetominaphen is Tylenol. Norco and Vicodin contain hydrocodone and acetominophen. Theoretically the combination helps with back pain, but clearly the acetominophen portion does nothing except endanger your liver if you take too much. There are different treatments and medications for acute versus chronic pain. If you have chronic pain it is best to see a specialist in treating chronic back pain and have the source of the pain diagnosed before treatment. Best treatment combines physical therapy, medication and other ways in addition to medication to cope with pain such a mindful meditation. It takes an active patient to deal with chronic pain.

      July 27, 2014 at 13:31 | Report abuse |
  6. Sarah Thebarge

    This article seems to confuse pain control with recovery time. These are two separate questions. 1) Does Tylenol relieve back pain? 2) Does Tylenol cause an injured back to heal faster? Because even if APAP doesn't improve recovery time (i.e., time it takes to fully recover from an injury,) if it offers adequate pain control in the meantime, it's still valuable.

    July 24, 2014 at 19:16 | Report abuse | Reply
    • Jenny

      @GIJoe.... Isn't Tylenol acetaminophen ????

      July 26, 2014 at 19:08 | Report abuse |
  7. ivan

    Acetaminophen by itself is USELESS!! Until its combined with CODEIN ! 500/5 will definitely relieve your back pain but it is definitely NOT a CURE! To get a true cure see your orthopedist doctor.

    July 24, 2014 at 19:24 | Report abuse | Reply
    • Absynthe J

      I can only WISH Codeine would help me.

      August 25, 2014 at 23:57 | Report abuse |
  8. Carolyn

    Self-acupressure. See Dr. Gach's website and use essential oils. You usually don't need pharmaceutical.s

    July 24, 2014 at 19:39 | Report abuse | Reply
    • Absynthe J

      Glad that works for you. Accupuncturists, Chiropractors nearly paralyzed me, while trying to "Cure" me. Good luck.

      August 25, 2014 at 23:59 | Report abuse |
  9. svann

    Time to recovery is not a valid measure of effectiveness of a pain reliever. Aspirin isnt intended to fix a sore back but instead is intended to lessen the pain.

    July 24, 2014 at 20:28 | Report abuse | Reply
    • gladr

      Actually, drugs like aspirin and ibuprofen are classified as anti inflammatory as well as analgesics. Since a lot of pain is associated with inflammation, anything that reduces that inflammation also reduces the pain. And in some cases, the length of time to recovery will be reduced because of the reduction and relief of symptoms of inflammation.

      July 25, 2014 at 20:20 | Report abuse |
  10. HH

    Acetaminophen doesn't help? DUH!!!!! That's what chronic pain patients have been telling their docs for years. Aspirin and ibuprofen don't help, either. The docs consider us all drug addicts and leave us to suffer. People with chronic back pain – usually from nerve damage – don't realize how horrific it is until someone famous like Dick Trickle shoots himself over it. Then it's news for a couple of days.

    July 25, 2014 at 10:51 | Report abuse | Reply
    • CKS

      Opioids have not been found to be effective for long term chronic pain. There are no studies to support that. There are weak studies performed to support some aspects of its use but not much. This in addition to the serious side effects of immune suppression, osteoporosis, opioid induced hyperalgesia, and sex hormone dysfunction make it a drug a lot of us pain doctors don't want to prescribe. Patients don't seem to get it. You wouldn't want a statin that didn't improve your cholesterol would you? How about one that actually caused the SE's listed above? You wouldn't do it right? A PCP surely wouldn't write it would they if they knew that? So, why do you keep asking for it when we explain why we won't write it?

      July 25, 2014 at 12:43 | Report abuse |
    • GI Joe

      Ibuprofen is for infections, not so much pain.

      July 25, 2014 at 14:23 | Report abuse |
    • HH

      Docs like you are the problem, CCS. You tell us to just live with it – easy words when YOU aren't the one suffering. You let us commit suicide, sometimes writing down that it's "drug related" although it was really pain-related, and forget about us. We know you don't care.

      August 6, 2014 at 17:48 | Report abuse |
    • Absynthe J

      Right on, HH! Tylenol & it's APAPs have done me so little, I've actively tried to do so much, yet all I've been left with is a DECADE IN BED, because of the PAIN & AGONY from spinal injuries.

      August 26, 2014 at 00:01 | Report abuse |
  11. miscreantsall

    Nothing works.

    Not gabapentin (600mg) at more than 6 pills a day.

    Not meloxocan either.

    Surgery has mixed results.

    Injury from work related activities are forever debated with workers comp and the "employer".

    Partial pain relief with side effects is the current state of affairs!

    July 25, 2014 at 11:31 | Report abuse | Reply
    • CKS

      Exactly. Pain relief is the key, but not without side effects. As most pain doctors will tell you. The goal is partial pain relief, not pain elimination at this point in time with our current research. Realistic expectations should be set at the first visit. We didn't cause your pain but your can be assured that we are trying to make it better.

      July 25, 2014 at 12:44 | Report abuse |
  12. Farrok

    Sorry to break the War on Drugs model but for severe pain the only thing that works is opiates when it is severe or Celebrex/Marijuana. The rest of the medications are a joke. When the opiates given = the pain you will never become addicted.

    Physicians are frightened to death of the DEA and as a result they will Not treat pain properly. Even in a hospital setting physicians are not treating pain properly due to the constant meddling of the government in their practice and the fear of it. When it's easier to purchase Afghani Heroin on a public street conner than receive treatment for pain from a physician than something is seriously wrong.

    There have always been addicts and there will always be addicts. No government can stope abuse of anything, The Drug War needs to End and the people who are addicted need medical attention not a prison term.

    It's not the Drug it's the Need.

    July 25, 2014 at 12:45 | Report abuse | Reply
    • CKS

      Not true. At all. Are physicians afraid of being prosecuted...you bet. That isn't the reason that a lot of docs don't write it. They don't write it because there is no evidence to support its long term use. There are not studies at all to support it. Everyone wants to focus on evidence bases medicine until it comes to a medication that people want. We use >80% of the worlds opioids and >99% of the worlds hydrocodone in this country (4% of the worlds population).

      Opioids have not been found to be effective for long term chronic pain. There are no studies to support that. There are weak studies performed to support some aspects of its use but not much. This in addition to the serious side effects of immune suppression, osteoporosis, opioid induced hyperalgesia, and sex hormone dysfunction make it a drug a lot of us pain doctors don't want to prescribe. Patients don't seem to get it. You wouldn't want a statin that didn't improve your cholesterol would you? How about one that actually caused the SE's listed above? You wouldn't do it right? A PCP surely wouldn't write it would they if they knew that? So, why do you keep asking for it when we explain why we won't write it?

      July 25, 2014 at 12:48 | Report abuse |
    • HH

      CKS, we ask for it because we are suffering. We lose jobs, custody of our kids and all enjoyment in life because our pain keeps us from functioning. Yet you wonder why we beg for relief.

      August 6, 2014 at 17:49 | Report abuse |
  13. Farrok

    CKS: This is all nonsense. This anti Opiates propaganda is just that, propaganda. It's just an extension of the Failed Drug War. It's hokum and swill. Addiction is 80% psychological and 20% physical.

    July 25, 2014 at 13:11 | Report abuse | Reply
    • CKS

      What is nonsense. I didn't say anything about addiction. In the right patient population addiction is almost nonexistant. I am talking about the majority of opioids prescribed in this country for non-cancer pain. Also, 80/20 for addiction, where did you get those number? I need real references please and you better be able to back up the study. They shouldn't be started in the first place. It's evidence based medicine. I know no one on here reads the studies nor do they know how to interpret them. I get that. Its not expected that you do. Yet, everyone on here is an expert about it. You have no idea what the data shows yet the physicians are all power hungry idiots who want to keep you in pain right? Its the same thing for antibiotics. My doctor said I don't need an antibiotic but I need one because I don't feel good. He didn't give me one so now I A.) complained to the clinic/hospital and B.) went and found a new doctor. People on here don't care WHY doctors say what they do. Period. They expect something and they will get it or complain. Your the reason no one wants to take care of you.

      July 25, 2014 at 13:21 | Report abuse |
    • Inphinity9@yahoo.com

      Don't waste your time. @CKS is likely not a physician, considering the spelling and grammatical errors. And for those of you suffering with true, chronic pain from a legitimate nerve injury – see a real pain management physician. Research his or her educational background. There are good pain management physicians who understand pain treatment and the effects of medications, narcotic or not who can help you make the best choice for you. If you go to a pain dr who wants cash payment and minimal records, go elsewhere – you are being ripped off. Also, there have been some western medicine studies that indicate acupuncture can help some back pain patients as can a slow movement program such as Tai Chi or Qi Gong.

      September 11, 2014 at 00:09 | Report abuse |
  14. Conrad Shull

    The best over the counter treatment for back pain is two acetaminophen and three ibuprofen taken together.

    July 25, 2014 at 14:17 | Report abuse | Reply
  15. GI Joe

    The Ibuprofen is strictly for inflammation and swelling. NOT for pain relief.

    July 25, 2014 at 14:25 | Report abuse | Reply
    • CKS

      GI joe: That's not true about not being for pain relief. It inhibits enzymes responsible for the production of prostoglandins...important mediators of pain. The issue is that most people don't believe what your saying but there are a select few who will.

      July 25, 2014 at 15:19 | Report abuse |
    • cks

      You need to look at the difference between Tylenol and acetaminophen. You need a basic understanding of pharmacology before you start posting.

      July 25, 2014 at 15:45 | Report abuse |
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    July 25, 2014 at 15:28 | Report abuse | Reply
  17. InfinitusMax

    Hydrocodone works great, but it's not OTC and highly addictive.

    July 25, 2014 at 17:24 | Report abuse | Reply
  18. JOE b

    According to the aritcle, "Despite the results of the study, scientists caution that acetaminophen as a low back pain treatment shouldn’t be dismissed until further research is conducted."

    They failed to mention one thing. These scientists work for the makers of acetaminophen. My friend don't take acetaminophen for anything. It doesn't do anything other than destory your immune system and liver.

    July 25, 2014 at 22:40 | Report abuse | Reply
    • CKS

      That's not true, at all. Unless you can point to proof of that. Yes, per the article (which I am sure you read) GlaxoSmithKline did provide money for the research. Maybe you could say they somehow influenced the study to make it look bad for Tylenol. I am sure you read the study and analyzed it though....correct? You saw that it was a good or bad study? I mean, you know how to interpret medical studies correct? They put that last line in there as they know that there study doesn't address a lot of questions that could be raised based on their selection criteria, etc.

      Also, are there studies showing not only an effect on the immune system that actually correlates to an increase in disease states? There is a lot of crap on the internet but you need to be able to weed through it.

      July 26, 2014 at 01:35 | Report abuse |
    • CKS

      Didn't mention it before, GSK doesn't make Tylenol, a subsidiary of J&J does.

      July 26, 2014 at 01:36 | Report abuse |
  19. Katie

    Tylenol helps some people with pain relief, but Tylenol doesn't cure anything, ever, and like other analgesics, can mask an underlying problem and can cause kidney and liver troubles in large and/or continuous dosing. People should not use alcohol AT ALL when taking Tylenol, and they should understand that Tylenol (acetaminophen) is included in many other OTC drugs as well as some narcotics (ie Vicodin, Darvocet, Percocet) so it's very easy to overdose on it. Tylenol also is not an anti-inflammatory, which is one reason why it does little for most people's strains or arthritis – inflammation can cause pain all by itself.

    There are many other things people can do to alleviate their back pains, depending on the underlying problem (for which everyone should first see a health care professional.) Lose weight. Stretch. Strengthen the abdominal muscles. Pay strict attention to posture and body mechanics (how you lift something). It takes personal responsibility. Unfortunately, there are too many people too willing to be proud of their "bad back" instead of doing something about it.

    July 27, 2014 at 11:42 | Report abuse | Reply
    • CKS

      That is exactly right. The medications are for symptoms only. There is no cure with any of this medication....from tylenol to opioids to membrane stabilizing agents. Nothing is changing the anatomy. Some patients will heal/improve over time but that is not the purpose of the medication. Its use is as a bridging agent until that occurs.

      July 27, 2014 at 21:12 | Report abuse |
  20. itzybellababy

    Arnica has been pretty helpful for me to reduce inflammation- I have broken the same stupid toe 3 times and it really takes the swelling down fast.

    July 27, 2014 at 13:20 | Report abuse | Reply
  21. Daffiest Manx

    People on opiates are treated like Criminals by the Doctors office that prescribes them and the Pharmacists that fill them. Its not a fun feeling to deal with that all the time. I was there once. You have people out there who cannot afford to have surgery for their medical problems as they have no insurance, job, etc. This is the only way to control their pain thats affordable for them. Thank God I only have slight back problems that act up only every once in a while. That is the worst pain I have ever experienced in my life! And its only slight pain. Childbirth has nothing on it. I have friends and relatives that live with severe back pain 24 hrs a day. I don't think I could take it, if I had to live with that and it wasn't under control. I guess they would rather these people blow their brains out than get addicted to anything. Hmmmm, addiction vs suicide? Let me choose

    July 27, 2014 at 19:51 | Report abuse | Reply
    • CKS

      Why would I, a pain management doctor, prefer to see you suffer? Do I get paid more with that? Do I like seeing people in pain? Think about it.....why does your doctor not write for the medication and/or make you "feel like a criminal" for taking it? Is it a power trip? There has to be a reason right? Are you telling me that no one has explained the heightened sense of concern when you ask for that medication?

      July 27, 2014 at 21:09 | Report abuse |
  22. Benjamin Watson

    HI,
    I just finished reading the content and that was very helpful. For more information please take a look at aching back.

    July 28, 2014 at 02:24 | Report abuse | Reply
  23. MutantSubhuman

    Tylenol is good for destroying your liver – not much else.

    July 28, 2014 at 10:23 | Report abuse | Reply
  24. Dan

    You know what does "cure" back pain. Active care and spinal manipulation. Every spinal joint has small meniscoids (similar to the ones in your knees) These can be stressed, bent, torn, etc. like your knee. This leads to inflammation. Inflammation leads to pain. The problem is usually there long before you realize it. Like a tooth cavity, by the time it hurts, it has been there for a long time, worsening, and there is no such thing as a quick fix. Spinal manipulation relieves this stress and can allow the inflammation to subside and muscle spasms disappear and your have a normal range of motion.
    Obviously prevention is key, strong and stable core, good posture, minimize sitting, exercise, diet, and good sleep can keep you pain free. But when it gets you, consider a chiropractor, a good one, we are not all full of witchcraft, but there is a reason we do what we do.

    July 28, 2014 at 17:16 | Report abuse | Reply
  25. Jen

    FYI, APAP is another name for acetaminophen; therefore, by definition, Lortab, Vicodin, Percocet and anything else that contains APAP contains acetaminophen. Acetaminophen is just the generic name for Tylenol. Pretty elementary but reading misinformation on here drives me insane.

    July 28, 2014 at 17:56 | Report abuse | Reply
  26. junebugj

    Tylenol is NOT an anti-inflammatory. Only an analgesic, anti pyretic. Don't waste your time. Ibuprofen 800mg. three times a day is incredibly helpful IF you have no kidney issues. @ GI Joe, if the inflammation goes down so does the pain. Think about it. Narcotics do NOTHING FOR BACK PAIN, except make you an addict. I'm a nurse at the VA and we fight about this all day long. Our pain clinic sucks. We need chiropractic, acupuncture, massage, etc.. All they do is throw the pts. back on primary care and the pt. suffers. Back pain is manageable with appropriate treatment. Gabapentin, yes. But no one maxes it out! You can take up to 3600 mg. a day. No one is on that. 300 three times a day! And, btw, I WAS a back pain sufferer. I got mad and worked through it. Haven't had an issue in many yrs. Stop looking for a silver bullet. There isn't one.

    July 28, 2014 at 20:04 | Report abuse | Reply
    • CKS

      Exactly. People "try" a lot of stuff that "doesn't work" yet when you dig deep enough they never try the effective dose, couldn't handle the side effects, etc. Opioids are not made for chronic back pain as many studies have shown. It is unfortunate but a number of patients do have to live with a baseline level of pain. The mediciations and other modalities (PT, massage therapy, smoking cessation, etc.) are imperative to your overall pain management. Smoking cessation alone has been shown to help a number of patients as it is linked to chronic pain. People don't want to hear that. They want to hear that you have a magic pill that they can take and it all gets better tomorrow. We just aren't there. It takes a lot of work on the patients part.

      July 28, 2014 at 22:37 | Report abuse |
    • Absynthe J

      So glad, nursey, that you're a FREAKIN' EXPERT ON MY PAIN. NOT!!! NONE of that stuff helps me, for the most part.

      August 26, 2014 at 00:10 | Report abuse |
    • Inphinity9@yahoo.com

      @CKS Please cite the studies you are referring to.

      September 11, 2014 at 00:11 | Report abuse |
  27. john locke

    morphine, it's the only way

    July 29, 2014 at 05:15 | Report abuse | Reply
  28. Justin

    Marion's post stating (Hydrocodone Apap is NOT TYLENOL. It is a narcotic, and is very addictive.) should be removed. The app portion is Tylenol. This comment miss informs people at the risk of taking both together. This has resulted in thousands of deaths. This is a safety issue, please do the responsible thing.

    August 1, 2014 at 10:38 | Report abuse | Reply
  29. Cleveland Man

    CKS – Why don't you post that that opiates are not effective for chronic pain about 80 more times ? You never once stated that they are very effective for acute pain. Also, did you ever hear of exceptions ? I bet that study cited that there IS a small percentage of people for whom opiates are a good solution for chronic pain.

    Since the good doctor is ingrained with thinking we don't want hear what he says, he would be wise to realize WE CAN READ – sites like Mayo Clinic, Cleveland Clinic, WebMD and a few others (i.e. not 'Fred Has a Health Forum' sites). 99% of the time I already know what my issue is. I only need a doctor to confirm, prescribe, and monitor.

    To help those in pain (I am Rx'd opiates from time to time), to make your use of opiates go further potentiate them with ONE of the following: white grape fruit juice (check your Rx bottles for no warnings first); 500mg Alleve (can cause stomach bleeding so check your doc first); or the prescription medication Tizanidine if you are prescribed. Marijuana also has been shown to reduce the amount of opiates needed, so this is another way to stretch your pain medication.

    Tylenol (easier than spelling ac ... whatever) is only useful to reduce a 2 year old's fever. For adults, it's the biggest example of snake oil I can think of. And if there ever was a drug where the risks outweigh the benefits, Tylenol is it.

    August 2, 2014 at 16:15 | Report abuse | Reply
  30. arunlnaik

    There is a huge hue and cry about that article. We need to understand the intricacies of that study. The study subjects, their pain profile, the analysis pattern all need to be put in perspective before concluding that acetaminophen is a failure. Till that time acetaminophen will be cornerstone of therapy in back pain for physicians like me.

    Dr Arun L Naik MD
    http://www.neurospinesurgeonindia.com

    August 4, 2014 at 07:25 | Report abuse | Reply

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