Acetaminophen

FRIDAY, March 21, 2025 -- There are a ton of suggestions out there for soothing an aching lower back -- acupuncture, heat, cannabinoids, muscle relaxants, TENS electrical pulses, dry cupping, opioids, massage and more. But not much actually eases back pain, including those suggestions, according to a new evidence review. Only painkillers like aspirin or ibuprofen -- non-steroidal anti-inflammatory drugs (NSAIDs) -- have been shown to be moderately effective in treating short-term lower back pain based on available medical evidence, researchers concluded. There’s also some evidence that five other treatments might help long-term low back pain, researchers said -- exercise , spinal manipulation, taping, antidepressants and warming creams containing ingredients like capsaicin . Overall, only 10% of treatments for low back pain had any medical evidence supporting their potential effectiveness, and even they didn’t work that great, concluded the review in the journal BMJ Evidence-Based Medicine . “Surprisingly, we found only around one in 10 was effective and most provided pain relief that was only marginally better than placebo – in other words, our review did not find reliable evidence of large effects for any of the included treatments,” Aidan Cashin , deputy director of the Center for Pain IMPACT at Neuroscience Research Australia, said in a news release. Non-surgical treatments are considered first-line care for back pain, Cashin said. Researchers performed the evidence review to see just how well these myriad therapies work. For the review, they analyzed findings from 301 clinical trials examining 56 treatments or treatment combinations for low back pain. Results showed that no sure-fire cures for back pain are currently available. Even ones with some evidence behind them can’t be counted on to work well for everyone. “We found for acute low back pain, NSAIDs may be effective. For chronic low back pain, exercise, spinal manipulation, taping, antidepressants and TRPV1 agonists (warming creams) may be effective,” Cashin said. “However, those effects were small.” Researchers also specifically highlighted five treatments that don’t work, based on the evidence. These included three for short-term low back pain – exercise, steroid injections and acetaminophen – and two for chronic back pain, antibiotics and anesthetics. For the rest of the treatments included in the research, there was simply not enough evidence to rule one way or the other, researchers concluded. More research is needed to prove whether or not these other back pain cures might have something to them. “We need further high-quality, placebo-controlled trials to understand the efficacy of treatments and remove the uncertainty for both patients and clinical teams,” Cashin said. “Placebo-controlled studies are the gold standard for evaluating the effects of treatments, with a clear need to better understand which treatments work for people with low back pain,” he added. In the meantime, Cashin recommends that people with back pain talk to their medical team to understand the treatments available and find one that works best for them. Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.

THURSDAY, March 20, 2025 -- Doctors should prescribe triptans for migraine patients who aren’t receiving relief from over-the-counter (OTC) pain relievers, according to a new clinical guideline from the American College of Physicians. The recommendation is based on an evidence review showing that adding a triptan to either a non-steroidal anti-inflammatory drug (NSAID) or acetaminophen worked better to quell migraine pain and headache than OTC products alone, researchers reported in the Annals of Internal Medicine . This combination therapy “resulted in a higher likelihood of sustained pain relief up to 48 hours after initial treatment and lower likelihood of using rescue medication at 24 hours,” compared with using a triptan alone, said the research team led by Dr. Carolyn Crandall , an internist with the UCLA School of Medicine. “In addition, combination therapy of a triptan and an NSAID probably results in a higher likelihood of achieving pain relief at 2 hours and sustained pain freedom at 48 hours,” researchers added. Triptan drugs treat migraines by changing the way blood circulates in the brain, and the way the brain processes pain signals, according to the Cleveland Clinic. “Using a triptan alone has historically been the first-line treatment of episodic migraine,” reads a summary for patients provided by the ACP. Episodic migraine occurs when a person has less than 15 headache days a month. By contrast, chronic migraine occurs when an individual has 15 or more headache days a month, notes The American Migraine Foundation. “Although using a triptan alone is an effective treatment option, ACP found evidence that supports better migraine-related outcomes with the use of a triptan plus a nonsteroidal anti-inflammatory drug or acetaminophen to treat episodic migraine,” the summary says. These new guidelines mean that doctors should adopt a step-wise approach to managing migraines, according to an accompanying editorial written by Dr. Marianna Shnayderman Yugrakh , a neurologist with the Headache Program at Columbia University Irving Medical Center in New York. However, Yugrakh said doctors should also think beyond the guidelines to fit treatments to specific patients. “An individual’s migraine symptoms may warrant specific drugs from a class, and patients whose symptoms vary by attacks may need several different treatments,” Yugrakh wrote. Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.