Paracetamol does little to ease hip and knee pain caused by the most common form of arthritis, a major study has found.
Scientists have warned that no matter how high the dose, paracetamol is ineffective against osteoarthritis, which affects up to 10 per cent of men and 18 per cent of women worldwide
The painkiller has traditionally been the main treatment for the joint condition, because although stronger drugs are more effective, paracetamol has fewer side effects.
However, growing evidence suggests that paracetamol does little to ease pain or improve movement, and yet still has side effects if taken in high doses over long periods.
NICE – the British National Health Service (NHS) clinical guidelines watchdog – advised doctors in 2013 to stop prescribing the pills for long-term treatment of osteoarthritis, warning of possible long-term impacts including heart, kidney and intestinal problems.
Yet other experts said that there were no safe to the painkiller – and Arthritis Research UK still advises patients that paracetamol can be taken for ‘mild to moderate’ pain caused by the condition.
Osteoarthritis is the leading cause of pain in elderly people and is more likely to strike women than men.
The new study, published in the Lancet medical journal, found that paracetamol does not meet the minimum standard of clinical effectiveness in reducing pain or improving physical function in patients with knee and hip osteoarthritis.
The Swiss research team found that although it was ‘slightly better’ than a placebo dummy pill, paracetamol ‘has no role’ in the treatment of patients with osteoarthritis, irrespective of dose.
The team, from the University of Bern, pooled data from 74 randomised trials involving 58,500 patients.
They found that diclofenac – a powerful painkiller – was the most effective treatment, but it comes with severe effects if used over the long-term.
The researchers said that diclofenac – or other similar NSAIDs (nonsteroidal anti-inflammatory drugs) – be considered for intermittent use.
But they said they should not be used long term.
Study leader Dr. Sven Trelle said: “NSAIDs are usually only used to treat short-term episodes of pain in osteoarthritis because the side-effects are thought to outweigh the benefits when used longer term.
“Because of this, paracetamol is often prescribed to manage long-term pain instead of NSAIDs.
“However, our results suggest that paracetamol at any dose is not effective in managing pain in osteoarthritis, but that certain NSAIDs are effective and can be used intermittently without paracetamol.”
Britain’s most senior GP said patients who take paracetamol should not panic – but called for more research into better treatments for the condition.
Dr. Maureen Baker, chair of the Royal College of GPs, said: “The majority of evidence still suggests that paracetamol is a safe drug for most patients, but a number of recent studies – today’s included – do cast doubt on its effectiveness at treating osteoarthritis….”
By Chukwuma Muanya [The Guardian]
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