Osteoarthritis: paracetamol and ibuprofen under the spotlight

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An Australian study in the prestigious BMJ published on 31/3/2015 provides new evidence that paracetamol is no better than placebo for lower back pain and its effect on osteoarthritis (OA) of the hip or knee is too small to be clinically worthwhile, despite being recommended as the first line drug treatment for both conditions.

The findings come months after another systematic review and meta-analysis questioned the routine use of paracetamol as a first line analgesic (pain reliever) in preference to ibuprofen, a non-steroidal anti-inflammatory (NSAID) or other analgesics. That study, published in the European Journal of Pain, shows that ibuprofen is usually superior to paracetamol for a range of conditions, including osteoarthritis.

“In osteoarthritis, some, but not all, people taking standard ibuprofen doses will have adequate pain relief; most of those taking paracetamol will not,” write the researchers from Oxford University.

Their study also shows ibuprofen may be better than placebo for back pain, although the evidence is weak.

However, the authors of this study note cardiovascular events with NSAIDs are a concern. This is supported in the Therapeutic Goods of Australia’s latest Medicines Safety Update that states NSAIDs should not be used in patients with cardiovascular disease and should only be used with caution in people with cardiac risk factors, such as smokers, patients with diabetes, high blood pressure, raised cholesterol, obesity etc.

Nonetheless, the Oxford University researchers conclude that ibuprofen “provides more patients with a degree of pain relief that patients feel worthwhile”. “Paracetamol may well be a useful analgesic in combination with others, but it has limited efficacy on its own,” they say.

They conclude that “neither of the drugs will be effective for everyone, and both are needed”

Low Level Laser Therapy provides excellent relief of the underlying issue which creates pain in joints affected by OA. While LLLT cannot restore the worn down cartilage of such joints, it can reverse the inflammatory reaction that poorly articulating osteoarthritic joints create. This inflammation causes much pain, swelling and dysfunction. Joints suffering OA that are particularly helped by LLLT include neck, low back, knees, fingers, thumbs, ankles and feet.

At Laser Pain Therapy, we have helped patients with OA enjoy resolution of, or significant reduction in pain, and restoration of function following a course of LLLT which is prolonged and lasting. So far it is our experience that such benefits may continue for up to 2 years, precluding the need for pain relieving medications which are now being shown to be ineffective or inadvisable due to systemic side effects and cardiovascular risk as stated by the studies discussed above.

While analgesics such as paracetamol, ibuprofen and other NSAIDs provide pain relief, they simply mask pain. This may be appropriate in some pain conditions. But in OA, LLLT helps to resolve the underlying cause of the pain and obviate the need for drug therapy and its related pitfalls.

Toorak, Victoria, Melbourne

Laser Pain Therapy Australia
Tok H Centre
Level 1, 459 Toorak Road
Toorak, 3142
Ph: (03) 8529 2225
Email us : info@laserpaintherapy.com.au

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We are dedicated to helping those in pain find relief that is safe, effective and affordable
We provide Low Level Laser Therapy (LLLT), or cold laser therapy, which is proven to offer a safe, non-invasive and painless solution to both acute injuries and chronic pain.

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