Research published recently in the UK medical journal The Lancet found that paracetamol offered no relief from arthritic pain. The research team from the University of Bern (Switzerland) studied data from 58,556 patients in 74 clinical trials between 1980 and 2015 and compared the effects of 22 different treatments including various doses of paracetamol and seven non-steroid anti-inflammatory drugs (NSAIDs) with a placebo.
They found the paracetamol had little or no effect on improving mobility and reducing pain and it was only slightly better than the placebo and did not meet the minimum standard of being clinically effective.
I am reminded of the need to be objective when reviewing clinical research, although it is unsettling when one of the former cornerstones of practice is removed. In truth this latest research is not unexpected. As the report says, the National Institute for Clinical Excellence recommended paracetamol was insufficient to treat the pain of chronic osteoarthritis three years ago, at a time when many thousands of patients were receiving it.
It has long been recognised that paracetamol is simply a pain killer, and therefore has no action on the progress of the disease itself, but it was and still is regarded and safe and in sufficient dose useful in alleviating the symptoms of the condition in many cases to allow people to maintain their mobility.
This latest study goes further and recommends that paracetamol has no place in the management of long term pain associated with osteoarthritis. On the one hand this reaffirms the severity of the condition for many sufferers, but on the other raises the questions of suitable alternatives. The researchers recognise that stronger analgesics and anti-inflammatory drugs both have side effects particularly when used continuously, which of course is common in any chronic condition.
People living with osteoarthritis reading this report may well feel despondent, although there is a positive side to it. As awareness spreads hopefully fewer people will be persuaded to rely on medication which is ineffective. Logically both patients and their physicians should turn their attention to newer, more effective long term solutions to the burden of knee pain, often beyond simple drug treatment.
The abstract of the study can be found on The Lancet website.