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Tylenol

Tylenol for Your Pain; Surprising Finding on How Well it Works

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Tylenol for back pain
Radosław Brzozo / Dollar Photo Club

Society would never consider going without over the counter pain meds. Doesn’t matter what’s it’s for; headaches, knee pain, shoulder pain, back pain.   We don’t seem to care where the pain is; that magical little pill hones in with radar precision to zap the pain and give you relief.

Or at least this is what the advertising messages would have you believe.

For starters, there is no magical honing; all drugs reach all areas of the body.  This is one of the reasons why so many side effects occur in organ systems that have nothing to do with the reason for taking a drug in the first place.

Personally, I haven’t taken any over the counter or prescriptive medications for at least 20 years (it may have been longer—I just can’t actually remember…) despite my share of martial arts injuries over the years.  But I certainly have my share of patients who take them on a regular basis.  We’ve become somewhat immune to the idea that every drug has a risk / benefit ratio.  There is not a drug out there that does not have side effects; since every single drug interferes with the way your body functions to some degree or another this is inevitable.

Paracetamol, the active ingredient found in Tylenol and generic acetaminophen, has a long list of side effects.  Just some of these include:

But, as mentioned, sometimes the side effects are worth the risk (although anyone on the liver or kidney transplant waiting lists may disagree…) so long as there are benefits.

But what if what you’ve been taking your Tylenol for really doesn’t work?  I can tell you that it certainly seems like many of my patients who are in pain and take many of the OTC pain medications aren’t jumping up and down for joy over how well they work (because, after all, they are in a chiropractor’s office looking for additional pain relief.

At the most, they seem to help “take the edge off” or help for a few hours at the most.  This particular study seems to agree with what I’ve experienced in my office.  In it, researchers looked across 13 different clinical trials looking at the use of paracetamol for back pain, knee or hip arthritis pain.  In the review, the researchers looked for the quality of the studies to see what the outcomes were.  Here’s what they found:

  • High quality results from the studies found that paracetamol is ineffective for reducing pain intensity and disability or improving quality of life in the short term in people with low back pain.
  • High quality results from the studies found that paracetamol used for hip or knee osteoarthritis for that any short-term improvement on pain and disability was not clinically important.
  • High quality results showed that those taking paracetamol were nearly four times more likely to have abnormal liver function tests.

When it comes to research, there are no absolutes and no single study can determine whether something works or not. To make it a little more complicated, there are good quality and bad quality studies.  But when you have multiple high quality studies pointing to the same outcome, you can be far more confident that the results from that study may apply to you.

That’s what we have here.  Could you be one of the few for whom Tylenol is going to work for back, knee or hip pain?  Possibly.  But it should not be your first choice given that there is a long list of side effects associated with the use of Tylenol and this review strongly suggests that it is not going to work.

Of course, being somewhat biased towards chiropractic care for these conditions, I would strongly suggest that chiropractic care should be your first choice for treatment of these conditions.

Dangers of Tylenol Use in Pregnancy; Use Chiropractic Instead

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Pregnant women are told to stay aware from steroids and ibuprofen because it can have direct effects on the developing baby, so OBs recommend Tylenol. This is a bad idea.

For starters, it has been known for a long time now that acetaminophen is linked to asthma in adults. Then someone asked if acetaminophen use in pregnancy could contribute to the development of asthma in the child after he or she is born. Turns out that the answer here is also a yes. Despite this information, OBs still recommend products like Tylenol for pain in pregnant women.

While my opinion on this topic may be slightly biased, it seems to me that chiropractic care during pregnancy is the ONLY safe approach that will in no way harm your little developing lima bean. Not only safe, but effective as well. Not too shabby.

Just in case you have no fear of your little one developing asthma from popping a few acetaminophen over the course of 9 months or so, hopefully this particular article will help sway you against over the counter wonder drugs.

From this study, I think the scariest take home message is that, out of 64,322 births (there may have been some twins mixed into these numbers, but essentially, it’s a LOT of births), over HALF had used acetaminophen during pregnancy. HALF!!! That just shocks me. Maybe it just illustrates how incredibly permissive we have become in society to drugs regardless of the situation. And understand that if there was ever a sensitive time in life it is during pregnancy.

Here’s the details of the study:

  1. Children whose mothers used acetaminophen during pregnancy were 37% more likely to have a hospital diagnosis of hyperkinetic disorder.
  2. They were 29% more likely to be on ADHD medications.
  3. They were 13% more likely to have ADHD-like behaviors at age 7.
  4. If acetaminophen was used in more than 1 trimester during pregnancy, these percentages were even higher.

Clearly there was a relationship between acetaminophen use during pregnancy and childhood behavioral problems years later. Is there any point at which society will stand up and say that ANY medication during pregnancy should be avoided unless absolutely, positively necessary?

All those pregnant women how had pain during pregnancy are likely cursing me now. However, I can tell you, from 15 years’ experience, that chiropractic care is VERY effective for most of the pains experienced in pregnancy, especially when you combine soft tissue methods along with the adjusting.

And yet, despite this, I find that few OBs will recommend chiropractic care before use of analgesics like Tylenol.

This has to change.

The Relative Safety of Ephedra Compared with Other Herbal Products – (03-31-03)

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The Relative Safety of Ephedra Compared with Other Herbal Products

Alright, while I rarely recommend ephedra containing products in my office, I need to speak up on this issue. First of all, ephedra products are greatly overused and the potential for abuse is high. But, in all, there have been maybe 20 deaths associated with ephedra over its recorded history. Not to minimize 20 deaths, but Tylenol kills that many in a month, let alone over it’s recorded history and yet no one is screaming for Tylenol to be pulled from the shelves. Make no mistake–the attack on ephreda is only the beginning of a slippery slope to make supplements prescription items to be prescribe only by doctors who have little or no training in these products.

Annals of Internal Medicine: Abstract

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Asthma increase could be caused by paracetamol use – (09-17-01)

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Asthma increase could be caused by paracetamol use

This is a perfect example of how many of the drugs that people take every day may not be as safe as they think. Paracetamol (acetominophen, Tylenol…) in this study shows a pretty strong link to asthma. Based on how widespread Tylenol use is, it is easy to see that this may produce some major impacts on community health. It’s always important to see why patients are using analgesics and try to fix the underlying problem so that taking the drug is not needed. Many parents use Tylenol to lower fever, and yet there are NO studies suggesting that lowering of the fever has any beneficial effects! Also interesting in this article was the finding that a child’s risk of asthma is markedly increased if one or both parents have asthma. What’s going to happen when today’s kids start having kids???

bmj.com Dyer 323 (7313): 592c

Read entire article here

Muscle Eccentric Exercise: Influence of Ibuprofen Acetaminophen – (11-01-01)

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Muscle Eccentric Exercise: Influence of Ibuprofen Acetaminophen

This is an interesting concept for all those weightlifters who frequently medicate their aches and pains with over the counter analgesics. This study shows that dosages of ibuprofen and acetaminophen (Tylenol) can inhibit the muscles’ ability to build after eccentric resistance exercises. Not to mention the fact that these have damaging effects on the GI tract, liver, kidneys and joint cartilage… My recommendation to weight lifters that rely on OTC pain meds–find a good chiropractors so you don’t need the pain relief. And, if you’re worried about post workout soreness, try proteolytic enzymes after a workout.

JCEM — Abstracts: Trappe et al. 86 (10): 5067

Read entire article here

NATURAL MEDICINE HIGHLY EFFECTIVE AS COMPARED TO OTHER MEDICINES – (09-24-03)

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The Relative Safety of Ephedra Compared with Other Herbal Products

This is a letter to the Editor by Dr. Julian Whitaker on the safety of ephedra. This herb has gotten a bad rap lately, but most adverse effects we have seen have been from overuse. People drop dead daily from LABEL use of Tylenol and ibuprofen but there’s no big congressional push to outlaw those two. Remember that natural medicine is held to a much higher standard and, more often than not, can withstand the additional scrutiny.

Ann Intern Med — Whitaker 139 (5): 385 -a.

Read entire article here

PARACETAMOL CAUSES LIVER FAILURE – (05-15-06)

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Paracetamol causes most liver failure in UK and US

That bottle of Tylenol looks so innocent on the shelf, doesn’t it? Ironic that Tylenol was pulled off the market for a mere week or so several yrs back when tampering was found that killed a handful of people, and yet it remains on the shelf when it is known to kill thousands more per year from untampered use. The dichotomy of our health care system is evident everywhere. A huge national uproar was raised when Tylenol was linked to several deaths from tampering, and yet barely a wimpier when it kills, on a daily basis, thousands more.

Read entire article here

IS MORTALITY DECREASING FROM ACUTE RENAL FAILURE? – (09-06-05)

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Has mortality from acute renal failure decreased?

We generally think of medical research as a good thing.  Billions of dollars go into new approaches, new treatment, new methods of detection.  But do they really change things?  In many cases, the answer is no.  How many untold billions have gone into AIDS research without anything even resembling a cure?  Many cancers still have high mortality rates.

This study reviews 50 years of technological advances in renal treatment, but finds no overall change in mortality rates.  I’ve said it a thousand times before and I will continue to say it–prevention is infinitely better than a cure.  Lets spend even a mere 10% of the large organizations’ budget (Amer Heart, Amer Cancer, Amer Diabetes) for prevention and we would see a huge return on investment in just a few short years.  Does everyone know that Tylenol and ibuprofen damage the kidneys?  Or that a large chunk of patients on dialysis got there because they took too much Tylenol?  Probably not.

Read entire article here