Paracetamol and reassurance will beat back pain

Bad back? All you need is a paracetamol and some reassurance, say doctors

FORGET STRONG PAINKILLERS and physiotherapy – all you need to cure a bad back is a paracetamol and a few words of reassurance from your GP, doctors conclude today.

Strong painkillers or spinal manipulation – massage by a physiotherapist – make no difference to the speed of recovery, researchers have found.

Back pain is the third most common reason for visiting the doctor after headaches and tiredness, and costs an estimated £1.6 billion to treat in Britain a year.

GPs are currently taught to reassure patients that they will get better and to advise them to keep active and avoid bed rest (which tends to make the condition worse), and to take a couple of paracetamol when required.

If that does not work they are advised to offer a stronger painkiller, such as the anti-inflammatory drug diclofenac, and spinal manipulation to facilitate recovery.

But an Australian study carried out on 240 patients with acute lower back pain showed that prescribing stronger painkillers and physiotherapy made no difference to recovery time.

The patients were split into four groups. Those who had the basic advice to stay active and take paracetamol got better just as quickly as those who were given the basic advice plus the stronger painkiller and spinal manipulation.

Writing in The Lancet, Mark Hancock and colleagues from the Back Pain Research Group at the University of Sydney, say: ‘Neither diclofenac nor spinal manipulative therapy gave clinically useful effects on the primary outcome of time to recovery.’

But a spokesman for the General Chiropractic Council defended the practice, saying: ‘Spinal manipulation is part of a package of care offered by chiropractors including lifestyle and posture advice, rehabilitation and specific exercises. The study did not address chiropractic techniques.’

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