Tramadol for osteoarthritis
OA is the most common form of arthritis. It can affect the spine and the hips as well as the limbs including the hands, elbows, shoulders, knees, ankles and feet. It is an inflammation of the joints which causes damage to the cartilage and resulting muscle problems. Cartilage is supposed to cushion the movement between the bones where friction would wear the surface of the bones. When the cartilage degenerates, the bones do begin to wear. This causes pain and swelling. To compensate for this pain, people change the way they move. In turn, this causes muscle problems. There is gold-level evidence that treatment with Tramadol over a three-month period may decrease pain, reduce stiffness and improve mobility. Generally, patients have reported a significant improvement in their sense of well-being. But there are a number of side-effects associated with Tramadol including headache, dizziness, nausea, vomiting, constipation and tiredness. These are usually transitory. But when patients experience these side-effects, they may stop taking the drug which limits the usefulness of Tramadol in treating a degenerative condition such as OA.
What drugs are used to treat it?
There are two main types of drug treatments. Analgesic drugs are used to Relief pain, but they do not affect the swelling usually associated with OA. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) such as Ibuprofen and the COX-II inhibitor drugs, are used to decrease both pain and swelling, but the most recent evidence shows that there may be enhanced risks of heart disease with some of the COX-II drugs. Tramadol is an atypical opioid that avoids the problems potentially limiting the use of other drugs including bleeding in the digestive and gastrointestinal tract, or impairment of kidney function. But it does not affect the cartilage at the end of the bones — none of the pain killers including Tramadol promote regeneration of tissue and all lose some or all of their effectiveness over time. When proposing to take any drug, it is important to know its strengths and weaknesses.
What do the studies show when Tramadol is used in the treatment of OA?
Those who participated in the double-blind studies took an average daily dose of 200mg, an NSAID, a different pain Reliefr or a placebo (an inactive tablet or powder). The time period for each study varied between one week and three months. |
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The benefits of Tramadol are that it may:
- decrease pain more than a placebo — subjective reports from those using Tramadol show a reduction in pain by 8.5 more points on a scale of 0 to 100;
- slightly decrease stiffness and slightly improve mobility more than a placebo — mobility may improve by 3.2 more points on a scale of 0 to 100;
- improve general physical condition — 69 out of 100 reported increasing flexibility and improved joint movement when the joint was under load;
- improve overall well-being — 50 out of 100 people reported a psychological improvement and a reduction in depression. Because the follow-up study was short, the evidence is not conclusive that Tramadol Reliefs the symptoms of OA more than other drugs. It is also not known whether Tramadol works well over prolonged use.
The disadvantages of Tramadol are that it may cause side-effects not reported by those taking a placebo:
- minor effects such as nausea, vomiting, dizziness, constipation, tiredness and headache were reported 18 out of 100 people in one study, and 39 out of 100 in a second;
- more major side-effects that would make people stop taking it were reported by 8 out of 100 people in one study, and 21 out of 100 people in a second.
