Paracetamol (acetaminophen) is no more effective than a placebo for improving pain levels in the lower back, speeding up recovery from acute episodes of lower back pain, or improving quality of life, function, or sleep, according to a new study. The large randomized trial is the first to compare paracetamol’s effectiveness against a placebo for lower back pain. The findings question whether paracetamol should be relied on as the first choice for lower back pain, the authors suggest.

The study findings were published in The Lancet.

The lead study author, Dr. Christopher Williams from the George Institute for Global Health at the University of Sydney in Australia, said in a statement, “Simple analgesics such as paracetamol might not be of primary importance in the management of acute lower back pain.” He continued, “The results suggest we need to reconsider the universal recommendation to provide paracetamol as a first-line treatment for low-back pain, although understanding why paracetamol works for other pain states but not low-back pain would help direct future treatments.”

Dr. Williams adds, “In view of the quick timeframe in which participants in our trial improved compared with other cohorts, it would be interesting to see whether advice and reassurance (as provided in our trial) might be a more effective than pharmacological strategies for acute episodes of low-back pain.”

According to drugs.com, paracetamol is a pain reliever and fever reducer. Its exact mechanism of action is unknown.