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Oral paracetamol and/or ibuprofen for treating pain after soft tissue injuries: Single centre double-blind, randomised controlled clinical trial

PainSci » bibliography » Hung et al 2018
Tags: medications, injury, self-treatment, treatment, pain problems

Five articles on PainSci cite Hung 2018: 1. Icing for Injuries, Tendinitis, and Inflammation2. The Complete Guide to Chronic Tension Headaches3. Heat for Pain and Rehab4. Guide to Repetitive Strain Injuries5. The Science of Pain-Killers

PainSci commentary on Hung 2018: ?This page is one of thousands in the bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.

In a test of ibuprofen vs paracetamol for hundreds of soft tissue injuries, there was no significant difference in the modest benefits or side effects, contrary to some past evidence and the widely held medical belief that ibuprofen is better for injuries (inflammation). It’s possible that placebo is powering the effects of both medications, and that's why they were equal, but it's impossible to know without a control group for this study. Note that the superiority of these medications is probably variable and not as clearly established as you might think.

~ Paul Ingraham

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

BACKGROUND: Soft tissue injuries commonly present to the emergency department (ED), often with acute pain. They cause significant suffering and morbidity if not adequately treated. Paracetamol and ibuprofen are commonly used analgesics, but it remains unknown if either one or the combination of both is superior for pain control.

OBJECTIVES: To investigate the analgesic effect of paracetamol, ibuprofen and the combination of both in the treatment of soft tissue injury in an ED, and the side effect profile of these drugs.

METHODS: Double-blind, double dummy, placebo-controlled randomised controlled trial. 782 adult patients presenting with soft tissue injury without obvious fractures attending the ED of a university hospital in the New Territories of Hong Kong were recruited. Patients were randomised using a random number table into three parallel arms of paracetamol only, ibuprofen only and a combination of paracetamol and ibuprofen in a 1:1:1 ratio. The primary outcome measure was pain score at rest and on activity in the first 2 hours and first 3 days. Data was analysed on an intention to treat basis.

RESULTS: There was no statistically significant difference in pain score in the initial two hours between the three groups, and no clinically significant difference in pain score in the first three days.

CONCLUSION: There was no difference in analgesic effects or side effects observed using oral paracetamol, ibuprofen or a combination of both in patients with mild to moderate pain after soft tissue injuries attending the ED.

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