Does paracetamol work for back pain and arthritis?

What it is

Paracetamol, also called acetaminophen, is a common pain tablet that people buy without a prescription. It has long been the first medicine suggested for back pain and for arthritis.

What the research shows

A review pooled 13 randomised trials that compared paracetamol with a dummy tablet.

For low back pain, paracetamol did not reduce pain, disability or quality of life in the short term. The difference in pain was about half a point on a 100 point scale, with a range from 3 points better to 2 points worse.

For hip and knee arthritis, paracetamol gave a statistically significant benefit, but a small one. Pain was about 4 points lower on a 100 point scale, and disability about 3 points lower. The reviewers judged this to be too small to matter to most people.

People taking paracetamol were nearly four times as likely to have abnormal liver blood tests. The reviewers said it is unclear how much this matters in practice.

Risks and effort

Paracetamol is safe for most people at the dose on the label. Higher doses can harm the liver. Check the label, and ask your pharmacist if you take other medicines that contain paracetamol.

What usually works instead

For knee arthritis, exercise and weight loss are well supported. See Does exercise work for knee arthritis? and Do NSAID gels and creams work for knee arthritis?. For low back pain, staying active is usual advice. See Low Back Pain.

Questions people ask

Is paracetamol harmful?

At the label dose it is safe for most people. The review found more abnormal liver tests, and the importance is unclear.

Should I stop taking it?

Talk to your doctor or pharmacist before changing any medicine.

Does it work better if I take it regularly?

The review did not settle this.

Sources

Select a source to read what the study or guideline found, in plain words, with a link to the original.

• 1BMJ review of 13 trials, 2015review

Last reviewed 24 October 2026. Next review due October 2028.