Society would never consider going without over the counter pain meds. Doesn’t matter what’s it’s for; headaches, knee pain, shoulder pain, back pain. We don’t seem to care where the pain is; that magical little pill hones in with radar precision to zap the pain and give you relief.
Or at least this is what the advertising messages would have you believe.
For starters, there is no magical honing; all drugs reach all areas of the body. This is one of the reasons why so many side effects occur in organ systems that have nothing to do with the reason for taking a drug in the first place.
Personally, I haven’t taken any over the counter or prescriptive medications for at least 20 years (it may have been longer—I just can’t actually remember…) despite my share of martial arts injuries over the years. But I certainly have my share of patients who take them on a regular basis. We’ve become somewhat immune to the idea that every drug has a risk / benefit ratio. There is not a drug out there that does not have side effects; since every single drug interferes with the way your body functions to some degree or another this is inevitable.
Paracetamol, the active ingredient found in Tylenol and generic acetaminophen, has a long list of side effects. Just some of these include:
- Liver damage (overdosing, intentional or accidental, can kill by shutting down the liver)
- Kidney damage
- Behavioral problems in children when used during pregnancy
- Asthma (either worsening existing cases or creating new ones)
- Blood cancers
But, as mentioned, sometimes the side effects are worth the risk (although anyone on the liver or kidney transplant waiting lists may disagree…) so long as there are benefits.
But what if what you’ve been taking your Tylenol for really doesn’t work? I can tell you that it certainly seems like many of my patients who are in pain and take many of the OTC pain medications aren’t jumping up and down for joy over how well they work (because, after all, they are in a chiropractor’s office looking for additional pain relief.
At the most, they seem to help “take the edge off” or help for a few hours at the most. This particular study seems to agree with what I’ve experienced in my office. In it, researchers looked across 13 different clinical trials looking at the use of paracetamol for back pain, knee or hip arthritis pain. In the review, the researchers looked for the quality of the studies to see what the outcomes were. Here’s what they found:
- High quality results from the studies found that paracetamol is ineffective for reducing pain intensity and disability or improving quality of life in the short term in people with low back pain.
- High quality results from the studies found that paracetamol used for hip or knee osteoarthritis for that any short-term improvement on pain and disability was not clinically important.
- High quality results showed that those taking paracetamol were nearly four times more likely to have abnormal liver function tests.
When it comes to research, there are no absolutes and no single study can determine whether something works or not. To make it a little more complicated, there are good quality and bad quality studies. But when you have multiple high quality studies pointing to the same outcome, you can be far more confident that the results from that study may apply to you.
That’s what we have here. Could you be one of the few for whom Tylenol is going to work for back, knee or hip pain? Possibly. But it should not be your first choice given that there is a long list of side effects associated with the use of Tylenol and this review strongly suggests that it is not going to work.
Of course, being somewhat biased towards chiropractic care for these conditions, I would strongly suggest that chiropractic care should be your first choice for treatment of these conditions.