Paracetamol is often used for pain relief, but research suggests it might only be useful in reducing pain for a limited number of conditions.
The University of Sydney conducted a systematic review across 44 pain conditions which found evidence of effectiveness for just four conditions:
- Knee or hip osteoarthritis.
- Tension headache (general, not migraine).
- Perineal pain after childbirth.
- Craniotomy.
There was strong evidence that paracetamol was ineffective for low back pain despite its common use, while for most conditions, such as abdominal pain or middle ear infection, it was unclear whether paracetamol relieved pain.
Lead authors Dr Christina Abdel Shaheed and Dr Giovanni Ferreira from the Institute for Musculoskeletal Health at the University of Sydney Faculty of Medicine and Health said that given the widespread use for pain relief, the Australian researchers reviewed all overviews of clinical trials testing paracetamol’s ability to relieve pain. This systematic review included 36 reviews (more than 19,000 participants) across 44 pain conditions.
“This review for the first time brings together all the existing evidence about the efficacy of paracetamol to treat pain in one document,” said Dr Abdel Shaheed, from the School of Public Health.
“For tension headache we know paracetamol works better than placebo – but for most other conditions we simply lack the evidence to be able to make strong or definitive statements about paracetamol’s effectiveness,” she said.
Dr Abdel Shaheed concluded that people should not be relying on pain medicines as a standalone treatment for pain relief.
“Any pain medicine should be considered as part of a holistic care plan, alongside strategies such as exercise, physiotherapy, or other lifestyle changes. A conversation with the doctor or pharmacist can be a good way to help people know what alternatives, subsidised or not, are available for them.”
Paracetamol is commonly used to treat muscle or joint pain, pain from injury or surgery, headache, general body aches or cancer-related pain and is a very common treatment for chronic, or persistent, pain.
The study did not look at the use of paracetamol for lowering temperature.
The review was published in the Medical Journal of Australia in addition to a companion feature in MJA Insight+.
