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Myth check

Does Tylenol help a tension headache? Not in the first hour

Across 23 trials, 1,000 mg of paracetamol, the drug in Tylenol, was no different from placebo at one hour. By two hours, 22 people had to take it for one more to be pain-free.

Acetaminophen (Paracetamol)

Many people assume Tylenol is a quick fix for an ordinary headache. In 23 trials of adults with frequent tension-type headaches, 1,000 mg was no different from a dummy pill at one hour. By two hours, 22 people had to take it for one more to be pain-free, and 10 for one more to be down to mild pain or none. Migraine was generally excluded; for tension headaches it helps a few more people than a dummy pill does, and not in the first hour.

The findings behind this

PainFor a tension headache, 1,000 mg did nothing at the one-hour mark

Across 23 trials and 8,079 adults, 1,000 mg of paracetamol was no different from placebo at one hour. By two hours, 22 people had to take it for one more to be pain-free.

★★★Well replicated — this finding’s sources average out to meta-analyses, systematic reviews or high-powered trials.This is frequent episodic tension-type headache of moderate or severe intensity, not migraine, which the trials generally excluded, and not the chronic form. Ask an easier question and the number improves: for pain-free or only mild pain at two hours it is 10, and for avoiding a second painkiller it is 7.8. No trial was at low risk of bias on every count, though the reviewers put most of that down to thin reporting rather than bad conduct. The senior author declares grants and fees from analgesic manufacturers.Click to keep this openRelieve painAcetaminophen (Paracetamol)

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