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Acetaminophen is one of the most commonly used drugs to relieve mild to moderate back and neck pain.

While acetaminophen is an over-the-counter (OTC) medication, it can have some dangerous side effects if taken in excess. However, it is extremely effective at elevating the pain threshold in the human body.

How Acetaminophen Is Used

Acetaminophen (brand name Tylenol) is used in many different types of medications. While acetaminophen is available over-the-counter in 650, 500 and 325 milligram doses, it’s also available as a combination with other types of medication.

For example, over-the-counter cold medications contain a mixture of acetaminophen, dextromethorphan and pseudoephedrine. These combination tablets can be used to treat a variety of symptoms like a runny nose, pain, fever, coughing and excess mucus.

Some prescription medications contain a mixture of acetaminophen and a stronger pain medication. Many opiate-based medications contain a mixture of both opiates and acetaminophen. For example, Vicodin tablets contain a mixture of hydrocodone and acetaminophen. By combining these different types of medications, it’s possible to achieve better relief from pain.

Acetaminophen can be used for many types of pain in the body. For example, it can be used to relieve arthritis pain, back pain, migraines, sore muscles and some fevers. However, it cannot reduce inflammation. While it can reduce the pain associated with inflammation, it will not be able to reduce the inflammation itself. Many people take a non-steroidal anti-inflammatory drug like aspirin or ibuprofen to relieve inflammation.

How Acetaminophen Works

Acetaminophen belongs to the class of drugs known as analgesics and antipyretics. Analgesics include all types of medications that can be used to reduce pain. Antipyretics are drugs that can reduce the symptoms of a fever. 

While acetaminophen has been in use for over 60 years, researchers are still unsure of its mechanism on how it relieves pain in the body. Several studies indicate that acetaminophen may inhibit an enzyme called COX in the body which is associated with several types of pain and inflammation mechanisms in the body though acetaminophen does not reduce inflammation. The effects seem to be acting on the central nervous system rather than at the site of inflammation or injury.  

As an antipyretic, acetaminophen reduces the symptoms of fever by interacting with certain parts of the brain. By changing heat regulation in the brain, acetaminophen is able to reduce body temperature by several degrees when one is sick.

Dosages and Health Risks

The average adult dose for acetaminophen is 325mg to 650mg every four to six hours. It’s important to avoid taking more than 3,000mg of acetaminophen in a 24-hour period. As mentioned before, it is important to know that some prescription opioid pain medications in the US also have acetaminophen combined in them (examples include hydrocodone and oxycodone) so it is important to consider these dosages as well when you are taking them. Since acetaminophen is metabolized by the liver, it can cause liver damage in higher doses.

When taking acetaminophen, it’s also important to avoid drugs that are also metabolized by the liver. This includes drugs like carbamazepine, isoniazid and rifampicin. In addition, it’s essential to avoid alcohol use when taking acetaminophen. Since alcohol is metabolized by the liver, the combination of alcohol and acetaminophen may cause liver damage.

While acetaminophen is generally safe when taken at the correct doses, it’s essential to avoid taking more than the recommended amount. A recent FDA study showed that almost 26,000 people are hospitalized every year from acetaminophen overdoses.

As with any drug, make sure to meet with your physician before attempting to self-administer dosage amounts, especially for chronic back pain conditions. Those with a history of back ailments should not take acetaminophen without a doctor’s consult.