Treating OA Pain: Does Acetaminophen Really Work?

Acetaminophen (also known as Paracetamol) is a commonly used over-the-counter painkiller that’s available under a range of different brand names, such as Tylenol and Excedrin. People have been turning to acetaminophen for everything from headaches and muscle aches to colds and fevers for years. Yet one question that many physicians get is “Does this drug works for osteoarthritis-related pain?”

Bottle of acetaminophen for OA patient

Acetaminophen is commonly used by patients suffering from arthritis pain.


According to a recent study published in the British Medical Journal (BMJ), acetaminophen offers little to no relief against osteoarthritis (OA) pain. This data was compiled from 13 randomized osteoarthritis clinical trials where acetaminophen’s effectiveness was also tested against back pain and neck stiffness.

Acetaminophen Appears to be Ineffective Against Osteoarthritis Pain

The really surprising find was that this drug seems to be completely ineffective against low back pain symptoms and can only offer minimal relief (at best) for OA pain in the knees and hip. The lead investigators for these clinical trials are now calling for an update to national treatment guidelines which recommend acetaminophen.

One of the lead authors for this research was Gustavo Machado of the George Institute for Global Health in the UK. Following the report, he said:

“Worldwide, paracetamol is the most widely used over-the-counter medicine for musculoskeletal conditions, so it is important to reconsider treatment recommendations given this new evidence.”


More Concerns Over Acetaminophen

Doctor examining man's back problems and spinal healthFollowing this news, many thought leaders in related fields such as rheumatology have expressed their lack of surprise over these new findings.

Professors Elaine Hay and Christian Mallen were quoted in the same issue of The BMJ. Apparently, many have been concerned about the value of this common painkiller for some time now. This level of speculation could make it more confusing for patients with osteoarthritis and their physicians when it comes to establishing a solid treatment plan.

On a more positive note, this research shows that lifestyle habits and physical therapy should play a more central role in your OA treatment plan. Running and other forms of exercise are key to long-term self management success. We’ve seen time and again how pharmacological guidelines can change dramatically.

In each osteoarthritis clinical trial, participants were either given acetaminophen or a placebo. The results showed that:

  1. Acetaminophen was not able to effectively reduce pain intensity or disability in patients with low back pain.
  2. The analgesic produces a clinically insignificant effect on osteoarthritis-related pain and disability.

A related study was published last year claiming that acetaminophen was ineffective at reducing low back pain.

Safety Concerns with Taking Acetaminophen for OA Pain

Patient discusses acetaminophen prescription with her doctorThe latest research also showed that taking acetaminophen could heighten your risk of liver malfunction– granted that was when tested against a placebo.

“Use of paracetamol for low back pain and osteoarthritis was also shown to be associated with higher risk of liver toxicity in patients,” explained Gustavo Machado. Again, this was included in the report, but it’s clinical relevance remains unclear.

Taking acetaminophen has inherent risks, just like any other drug. Reported side effects were not significant compared to any other painkiller. If you’ve been diagnosed with osteoarthritis, we still recommend following any and all guidelines established by your doctor. They will help you develop the best treatment plan possible.

If you’d like to learn more about acetaminophen (Paracetamol), we recommend checking



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