Editing Paracetamol (section)

====Musculoskeletal pain====
The benefits of paracetamol in musculoskeletal conditions, such as osteoarthritis and backache, are uncertain.<ref name="pmid31892511"/>

It appears to provide only small and not clinically important benefits in [[osteoarthritis]].<ref name="pmid31892511"/><ref name=BMJ2015>{{cite journal|vauthors=Machado GC, Maher CG, Ferreira PH, Pinheiro MB, Lin CW, Day RO, McLachlan AJ, Ferreira ML |title=Efficacy and safety of paracetamol for spinal pain and osteoarthritis: systematic review and meta-analysis of randomised placebo-controlled trials.|journal=BMJ |date=March 2015| volume= 350| pages= h1225| pmid= 25828856 |doi= 10.1136/bmj.h1225|pmc=4381278 }}</ref> [[American College of Rheumatology]] and [[Arthritis Foundation]] guideline for the management of osteoarthritis notes that the [[effect size]] in [[clinical trial]]s of paracetamol has been very small, which suggests that for most individuals it is ineffective.<ref name="pmid31908149">{{cite journal |vauthors= Kolasinski SL, Neogi T, Hochberg MC, Oatis C, Guyatt G, Block J, Callahan L, Copenhaver C, Dodge C, Felson D, Gellar K, Harvey WF, Hawker G, Herzig E, Kwoh CK, Nelson AE, Samuels J, Scanzello C, White D, Wise B, Altman RD, DiRenzo D, Fontanarosa J, Giradi G, Ishimori M, Misra D, Shah AA, Shmagel AK, Thoma LM, Turgunbaev M, Turner AS, Reston J |title=2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee |journal=Arthritis Care & Research |volume=72 |issue=2 |pages=149–162 |date=February 2020 |pmid=31908149 |doi=10.1002/acr.24131 |pmc=11488261 |hdl=2027.42/153772 |s2cid=210043648 |hdl-access=free }}</ref> The guideline conditionally recommends paracetamol for short-term and episodic use to those who do not tolerate nonsteroidal anti-inflammatory drugs. For people taking it regularly, monitoring for liver toxicity is required.<ref name="pmid31908149"/> Essentially the same recommendation was issued by [[European League Against Rheumatism|EULAR]] for hand osteoarthritis.<ref name="pmid30154087">{{cite journal |vauthors=Kloppenburg M, Kroon FP, Blanco FJ, Doherty M, Dziedzic KS, Greibrokk E, Haugen IK, Herrero-Beaumont G, Jonsson H, Kjeken I, Maheu E, Ramonda R, Ritt MJ, Smeets W, Smolen JS, Stamm TA, Szekanecz Z, Wittoek R, Carmona L |title=2018 update of the EULAR recommendations for the management of hand osteoarthritis |journal=Ann Rheum Dis |volume=78 |issue=1 |pages=16–24 |date=January 2019 |pmid=30154087 |doi= 10.1136/annrheumdis-2018-213826 |doi-access=free |title-link = doi }}</ref> Similarly, the ESCEO algorithm for the treatment of knee osteoarthritis recommends limiting the use of paracetamol to short-term rescue analgesia only.<ref name="pmid31126594">{{cite journal |vauthors=Bruyère O, Honvo G, Veronese N, Arden NK, Branco J, Curtis EM, Al-Daghri NM, Herrero-Beaumont G, Martel-Pelletier J, Pelletier JP, Rannou F, Rizzoli R, Roth R, Uebelhart D, Cooper C, Reginster JY |title=An updated algorithm recommendation for the management of knee osteoarthritis from the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) |journal=Semin Arthritis Rheum |volume=49 |issue=3 |pages=337–350 |date=December 2019 |pmid=31126594 |doi=10.1016/j.semarthrit.2019.04.008 |doi-access=free |title-link = doi |hdl=10447/460208 |hdl-access=free }}</ref>

Paracetamol is ineffective for acute low back pain.<ref name="pmid31892511"/><ref name="pmid28192789">{{cite journal |vauthors=Qaseem A, Wilt TJ, McLean RM, Forciea MA |title=Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians |journal=Ann Intern Med |volume=166 |issue=7 |pages=514–530 |date=April 2017 |pmid=28192789 |doi=10.7326/M16-2367 |s2cid=207538763|doi-access=free }}</ref> No randomized clinical trials evaluated its use for chronic or [[radicular pain|radicular]] back pain, and the evidence in favor of paracetamol is lacking.<ref name=Saragiotto2016>{{cite journal |vauthors=Saragiotto BT, Machado GC, Ferreira ML, Pinheiro MB, Abdel Shaheed C, Maher CG |title=Paracetamol for low back pain |journal=Cochrane Database Syst Rev |date=June 2016| volume=6| issue=6| page=CD012230 |doi=10.1002/14651858.CD012230 |pmid=27271789 |pmc=6353046}}</ref><ref name=BMJ2015/><ref name="pmid28192789"/>