When it comes to pain relief, there are few medications that are as well-known and trusted as paracetamol. It is one of the most used medicines in the world and has been in Australia since the 1950s.
The brand names of drugs that contain paracetamol include Panadol, Herron Paracetamol, Panamax and Dymadon, just to name a few, but paracetamol is sold under many brand names in Australia and internationally.
Paracetamol was for decades marketed as having abilities to provide targeted pain relief. As recently as 2016, pharmaceutical companies were advertising the ability of paracetamol to provide pain relief for specific conditions such as back and neck pain.
Pharmaceutical companies ceased these activities after a landmark ruling in the Federal Court which found that the manufacturer of Nurofen engaged in misleading claims for marketing their products to consumers as being able to target specific pain.
A study published last week in the Medical Journal of Australia found that the evidence is not clear that paracetamol medications are more effective than a placebo for the most common illnesses or injuries.
The findings indicate the most ineffective use of paracetamol is when it is taken for acute low back pain. In trialling paracetamol to treat almost 50 common pain conditions, it was discovered that only knee and hip osteoarthritis, craniotomy, tension headache and perineal pain after childbirth were better for managing pain than a placebo.
The study found that for the majority of pain conditions such as abdominal pain, pain during dental procedures, migraines and middle ear infection, it was unclear whether paracetamol relieved pain. Further research is required to determine its efficacy for managing pain.
The problem is that paracetamol has become so ubiquitous in the treatment of chronic pain that it is difficult to know how these new findings will be accepted and adopted in Australia. It seems Australians are being increasingly forced to make a big mind shift around the treatment of pain when it comes to the reliance on medication as the ‘go to’ treatment for pain.
It is interesting to note that many of the consumers in the Painaustralia network reacted to this research noting that for complex and chronic pain, they have long known that paracetamol has limited efficacy despite it being recommended to them throughout the management of their condition.
Following the restriction of opioid medication recently together with boxed warnings for medications containing pregabalin or gabapentin, the roll out of real time prescription monitoring and the exceptionally long wait times to see a pain specialist of at least a year, people living with chronic pain now appear to have even fewer medication options to help them manage their condition.
We know the lack of effective treatment options is a big issue for anyone living with chronic pain. Many have told Painaustralia they have turned to illicit drugs and alcohol to help them manage while others have said they are close to deciding that they would rather not continue to live at all. The effective options available to help people manage their pain appears to be dwindling by the day and this latest study into paracetamol is once again bringing to light something those working in the pain space already know: the 3.4 million people living with chronic pain need better support and better access to effective treatment options.
As I write this blog, we await the outcome of the consideration of the National Strategic Action Plan for Pain Management by all Australian governments almost two years from its launch. Any steps to improve access to pain management cannot come soon enough.
If you’ve been using paracetamol to treat your condition and now feel at a loss as to what to do, we’d like to hear from you so we can further gauge the impact of these new findings and share your story with others experiencing chronic pain.