Paracetamol is ineffective at treating back pain and osteoarthritis despite being a recommended treatment, a group of Australian researchers has warned.
Their review of 13 clinical trials, published in The British Medical Journal (The BMJ), said the drug did not reduce disability or improve quality of life.
Instead, the group warned, it increased the odds of liver problems.
The NHS is to review its guidelines. Experts say patients should consult a doctor before changing medicines.
Back pain is a leading cause of disability and in the UK alone it is estimated to affect 26 million people each year.
The National Institute for Health and Care Excellence (NICE), which establishes best NHS practice, currently recommends paracetamol for both lower back pain and for osteoarthritis.
A team at the University of Sydney assessed data from 13 drug trials involving more than 5,000 patients.
They concluded that paracetamol was "ineffective" at reducing back pain.
In osteoarthritis in the hip or knee, they found a small improvement with paracetamol. Yet the impact was so small it was "not clinically important".
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