A study published in the respected medical journal, The Lancet, affirms that paracetamol does not accelerate recovery or reduce pain resulting from acute low back pain.

Paracetamol, also called acetaminophen, is widely recommended as first-line treatment for people with acute low back pain. It is the world's most popular over-the-counter analgesic or pain reliever and antipyretic or fever reducer.

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The results of a large trial conducted in Sydney, Australia discovered that paracetamol is no better than placebo, or dummy pills, for accelerating recovery from acute attacks of low back pain or easing pain levels, improving sleep or quality of life.

Researchers said the results challenge the universal endorsement of paracetamol as a first line painkiller for lower back pain. Lower back pain is one of the leading causes of disability worldwide.

Christopher Williams, who led the study at the University of Sydney in Australia, said doctors need to reconsider the universal recommendation to provide paracetamol as a first-line treatment.

Every back pain treatment guideline in the world currently recommends paracetamol as the first-line analgesic for lower back pain.

Williams said this was so despite the fact that no previous studies have provided robust evidence that paracetamol works in this condition.

The trial saw 1,652 people from Sydney with acute low back pain randomly assigned to receive up to four weeks of paracetamol, either in regular doses three times a day, or as needed, or to receive placebos.

All those involved received advice and reassurance and were followed up for three months.

The results showed no difference in the number of days to recovery between the treatment groups. The average time to recovery came to 17 days for each of the groups given paracetamol and at 16 days for the placebo group.

The study said the number of patients reporting negative side effects was similar in all groups. It noted that the reasons for paracetamol failing to work for lower back pain were not well understood.

The study indicates that the mechanisms of back pain are likely to be different from other pain conditions, and this is an area that needs to be studied more.

The study, however, confirmed that paracetamol works to relieve pain for a range of other conditions such as headaches, some acute musculoskeletal conditions, toothache and for pain straight after surgery.