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