Intended for healthcare professionals

Letters Paracetamol, spinal pain, and osteoarthritis

Paracetamol should remain the first line option for persistent pain

BMJ 2015; 350 doi: (Published 28 April 2015) Cite this as: BMJ 2015;350:h2221
  1. Felicity C Veal, lecturer in pharmacy practice1,
  2. Angus J Thompson, lecturer in therapeutics1
  1. 1University of Tasmania, Sandy Bay, Tasmania, Australia
  1. Felicity.Veal{at}

Persistent pain in older people is a serious problem that is often undermanaged.1 Osteoarthritis disproportionately affects older people, yet they are often under-represented in trials. Furthermore, their response to analgesics may differ from that of younger patients owing to altered pharmacokinetics and pharmacodynamics.2

The fundamental question raised by this meta-analysis is, if we dismiss paracetamol from our armamentarium, …

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