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Systematic review with meta-analysis
Paracetamol is ineffective for spinal pain and knee and hip osteoarthritis
  1. David Felson1,2
  1. 1Department of Clinical Epidemiology, Boston University, Boston, Massachusetts, USA
  2. 2University of Manchester, Manchester, UK
  1. Correspondence to : Dr David Felson, Department of Clinical Epidemiology, Boston University, 650 Albany Street, X-200, Boston, MA 02118, USA; dfelson{at}bu.edu

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Context

While paracetamol continues to be recommended as an initial pharmacological treatment for osteoarthritis and to a lesser extent for back pain, increasingly trials and meta-analyses have suggested that its efficacy is minimal and some epidemiological evidence suggests that at high doses, paracetamol may be dangerous. Machado and colleagues carried out the most comprehensive meta-analysis yet of the efficacy and safety of paracetamol versus placebo for back pain, neck pain and knee and hip osteoarthritis pain.

Methods

The authors carried out a comprehensive search for randomised trials comparing efficacy and safety of paracetamol versus placebo for the aforementioned …

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