To think paracetamol is just a placebo?

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I have taken many over the course of my life, for a variety of different types of pain, mainly headache. However, I can't ever recall an occasion where paracetamol made the slightest bit of difference!!

Is it just a placebo!!?? A big con???

Or are some people simply not susceptible to it?

I fell off a second story balcony a few years back and landed (feet first, straight legs) onto the concrete patio. Completely shattered my pelvis, I was given Morphine in incredibly high doses but it did nothing compared to the IV paracetamol apart from making me feel like I was on another planet.

But if I take OTC paracetamol, nothing.

I think theres a couple of things happening..

Firstly people rarely take painkillers properly - as mentioned up thread, 2, every 4 hours and start taking them as SOON as you realise you need to, rather than 'wait and see if it goes away on its own'.

Secondly I think there is a reverse placebo effect - everyone 'says' that Paracetamol doesn't work, everyone believes it doesn't work... so they don't believe it will work and ..... still feel pain.

Funnily enough almost everyone who thinks paracetamol does not work on THEM, when given IV paracetamol, finds it not only works, but works extremely effectively to the point that they are really quite shocked.

IV paracetamol works no differently AT ALL to oral paracetamol, with the exception of the rare few people who have a gastric issue that stops them digesting stuff - and that is a TINY percentage of the people who think Paracetamol does not work, it certainly does not account for all of you or even most!

Why does IV paracetamol appear to work better?

Because its given IV and we are all conditioned to think that IV drugs are 'serious' and 'more powerful' and 'stronger' of course.

The placebo effect is extremely powerful!

They are very mild but I do find them helpful. I never used to but they can definitely take pain for me down from "This is unignorable, I can't concentrate on anything" to "I can feel it but it's not so bad now".

For headaches, period pain and post-op pain I found them useful. DH also using at the moment for his foot which he broke a couple of months ago. Again they take the edge off on bad days.

I don't think they would work for serious bad pain.

IV painkillers work faster though, don't they? When I've had IV paracetamol it seems to take effect within a couple of minutes whereas for oral you have to wait 15 to 20 minutes, by which time you might be distracted.

For me, ibuprofen for period pain, or paracetamol & codeine (effective but can cause constipation which can aggravate my period pain further). Paracetamol doesn't really touch it, although it's better than nothing if I have run out / can't get hold of any.

Colds, mild headaches - paracetamol is fine.

Flu, toothache - anything and everything I can get my hands on...! Paracetamol would be my first choice for flu, but I might well follow it up with ibuprofen 2 hrs later. That reminds me, I must book my flu jab...

I took paracetamol for the first time in years recently and it worked better than I remembered. I was also surprised as I have a very low pain threshold and essentially need to be asleep/unconscious to not be in pain (stopped using Feminax on periods as it was useless). Ibuorofen usually works on headaches after the second dose. The best (and cheapest) brand for both Paracetamol and Ibuprofen is Alexanders. Probably a placebo but they work fastest!

Morphine doesn't work on me but a lovely paracetamol IV drip does.

I can't recall a single occasion in my 41 years where paracetamol has had any effect on my whatsoever, as a painkiller. Even when I was a child and I truly believed it would work. It has reduced my temperature many times though, so I would use it for that.

Ibuprofen works reasonably well for minor pains, but I can't take it now due to stomach problems. So it's the hard stuff or nothing for me now! As a result I only take painkillers if something is very very painful, otherwise I'd be an addict by now with my chronic back pain.

Works well for me. Recovering from fairly major surgery while bf, pain med options limited. Morphine pump for the first few days, as well as IV paracetamol. Ditched the morphine as soon as I could as it made me feel awful. IV paracetamol was brilliant. Moved to oral just before discharge and continuing with that now, managed to get it down to 2 doses per day and think I will stop that soon.

Dr said to me it only works effectively if in your system so rather than taking two randomly, you need to take 8 over 24 hrs

It works well for me when I need it and I'm thankful that it's around as I'm allergic to aspirin so cannot use ibuprofen.

works really well for me, especially for things like tooth ache and head ache. I have 3 dc and ehen they have a fever it's really effective in bringing it down, but only for 2 of them. The other one, it has ne effect whatsoever. I think pharmacologically it is perfectly feasible that some people will have variant receptors that dont bind or uptake paracetamol as well. But i dont know, any pharmacologists who can confirm?

interestingly, the dc for whom paracetamol doesnt seem to do anything does seem.to experience pain differently from the other two. He finds things much more intensively painful and things that barely bother them like string sunlight or insect stings really hurt him.

Of course it works, if you use it properly. It's a bloody good pain reliever.

My mum had a triple heart bypass, in intensive care and then a normal ward for a week. When she left hospital, she was only given paracetamol to take, with strict instructions to take it on the dot, 4 times a day, every 4 hours.
Now when you know what they do to your body, especially your chest, during a tripe heart bypass,"just paracetamol" really shocked me but she needed nothing else's at all for pain relief.

I've also had 2 Csections and after the initial morphine for around 12 hours, had nothing but paracetamol. It worked really well!

Paracetamol is a powerful analgesic but pain is complicated with a huge psychological element. There are those who claim paracetamol doesn't work because they believe their pain is too strong for it and they 'need' something stronger. There is too much reliance on prescription pain killers but then there's inadequate access to mental health/ chronic pain services.
GPs pare forced to prescribe unececcessary drugs because there is little else they can do and patients get so cross and demanding if you tell them to exercise instead. Litigation has a lot to answer for.
People with bad backs don't need tramadol swimming is better than either drugs or surgery when the effects are reviewed after a year.
People fret about cancer but continue to drink alcohol whilst worrying about tin cans (not analgesic but same issue). People want the easy way not the effective way.

I'm sure I read an article that some people just don't respond to it....off to Google

It wast psychological in my case. I used to take it and have faith that pain would abate in half an hour. It took me a while to see clearly, no, this drug never relieves my pain.

Two nurofen is hardly bring in the big guns but it does work so it's not like i believe my pain is so extreme it needs to do ten rounds with vicodin.

2 nurofen has a noticeable effect. Paracetomol hss no effect whatsoever.
It toik me a while to have faith in my own observations in fact.

I was on liquid paracetamol after a Tonsillectomy and carefully timed it. It worked and definitely wasn't a placebo. As anyone whose had a Tonsillectomy will tell you.

They also work if I take two as soon as I get a headache twinge, then time another two. Otherwise I get a migraine. These are only very occasionally.

I have joint pain and don't bother taking them for that, they aren't effective and I want to protect my kidneys.

They are good for high body temperatures.

Crumbs - I needed surgery on my back. When you're in so much pain on 4 grams of paracetamol, diazepam, morphine, dihydrocodeine and naproxen that you can't work, swimming isn't an option

I find it great for most headaches and it helps with many flulike symptoms of a bad cold. It takes the edge of period pain for me but not enough, Feminax Extra is my friend in need there. It's not great for back or joint pain in my experience.

Exercise is great for bad backs. Unless like me you have a spine riddled with arthritis in which case no. No it's not. A muscle twinge and a mild prolapse disc yes exercise is definitely the best thing to do

Ollivander sorry your back's bad but the statistics are that a year after surgery the outcomes are the same regardless of treatment or not - that doesn't mean every case but considering a large sample.

The Cochrane collaboration has found paracetamol to be no better than placebo for low back pain, and the article linked below this discusses how there is little evidence that paracetamol is better than placebo in a multitude of conditions. There are links to the primary research at the end of the article, and other discussing that it may have a role to play in lowering temperature in the comments.

uk.cochrane.org/news/paracetamol-widely-used-and-largely-ineffective

Crumbs - I would have been paralysed without the surgery and incontinent so not having it wasn't an option

@ollivander I take my hat of too you, I seriously don't know how you have coped. Damaging my coccyx and needing Valium for slipped disc I found unbearable enough. @crumbs1 is a joyful ray of sunshine that is like a gift that just keep giving everywhere

Never does anything for pain for me but works for temperature.