Tramadol

Tramadol is a prescription painkiller that can be used to manage arthritis pain. It’s an opioid medication that works by changing the way your brain perceives pain. Opioids bind to specific receptors in the brain, spinal cord, and other body parts. These receptors are known as opioid receptors and are part of the body’s pain control system. When opioids attach to these receptors, they block the transmission of pain signals to the brain and alter the perception of pain.

Opioids can also trigger the release of dopamine, a neurotransmitter associated with pleasure and reward, leading to feelings of euphoria and relaxation. This is the key factor that leads to addiction among its users.

Tramadol is an alternative treatment option for osteoarthritis (OA) aside from other treatments. This is especially true for people who have failed treatment with acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) or cannot take these medications.

It is sold under the brand name Ultram®, Ultracet and Ultram® ER (extended release), among others.

Tramadol typically begins to work within one hour.

A recent guideline from the American Geriatrics Society recommends that all older patients with moderate to severe OA pain or diminished quality of life be considered for opioid therapy such as tramadol because the risks of NSAIDs in these patients, including cardiovascular risk and gastrointestinal toxicity, may be serious enough to outweigh the potential for addiction. 

Tramadol is also not associated with kidney problems, unlike some other OA medications.

How It Works:

• Pain Relief: Tramadol helps alleviate moderate to severe pain by binding to opioid receptors in the brain.
• Non-NSAID Option: Unlike NSAIDs (e.g., ibuprofen), tramadol does not cause stomach or kidney issues.

Usage:

• Dosage: Tramadol comes in various forms, including tablets, capsules, drops, and injections. The dosage and frequency depend on the severity of the pain and individual response.
• Administration: It’s important to follow your doctor’s instructions on how to take tramadol, as it can be addictive.

Effectiveness:

• Pain Reduction: Studies have shown that tramadol can reduce pain by about 4 points on a 0-100 scale compared to a placebo. A placebo is anything that seems to be a “real” medical treatment but isn’t. It could be a pill, a shot, or some other type of “fake.
• Physical Function: It can also improve physical function by about 4% compared to a placebo.

Side Effects:

• Common Side Effects: Nausea, vomiting, dizziness, constipation, tiredness, and headache.
• Serious Side Effects: There is a risk of dependence and other serious side effects, so it should be used under medical supervision. Recently, Arthritis Research Canada has found that people with osteoarthritis who started taking tramadol, were at a 20-50 percent greater risk of mortality, 70 percent greater risk of blood clots, and 40-60 percent greater risk of hip fractures when compared to people who started using drugs like aspirin or ibuprofen.

What helps to reduce side effects?

Reducing the side effects of tramadol involves several strategies and careful management. Here are some tips:

1. Follow Your Doctor’s Instructions:

• Dosage: Take the prescribed dose and avoid self-adjusting the medication.
• Timing: Stick to the recommended schedule to prevent withdrawal symptoms and manage pain effectively.

2. Stay Hydrated:

• Fluid Intake: Drink plenty of water to help prevent constipation, a common side effect of opioids.

3. Diet and Fiber:

• High-Fiber Diet: Include plenty of fruits, vegetables, and whole grains in your diet to promote regular bowel movements.
• Fiber Supplements: Consider fiber supplements if dietary changes are not enough.

4. Regular Exercise:

• Physical Activity: Engage in regular physical activity to help with bowel movements and overall well-being.

5. Use of Laxatives:

• Stool Softeners: Over-the-counter stool softeners can help alleviate constipation.
• Prescription Medications: Your doctor may prescribe medications to manage constipation if it becomes a significant issue.

6. Monitor for Side Effects:

• Report Issues: Inform your doctor if you experience severe side effects like severe constipation, dizziness, or difficulty breathing.

7. Gradual Reduction:

• Tapering Off: If you need to stop taking tramadol, your doctor will likely recommend a gradual reduction to minimize withdrawal symptoms.

8. Alternative Pain Management:

• Non-Opioid Medications: Use over-the-counter pain relievers like acetaminophen or NSAIDs when appropriate.
• Non-Pharmacological Methods: Consider physical therapy, acupuncture, massage, and other non-drug therapies.

9. Mental Health Support:

• Counseling: Seek support from a mental health professional to manage anxiety or depression that may arise from chronic pain or opioid use.

By combining these strategies, you can effectively manage and reduce the side effects of tramadol. Always consult with your healthcare provider for personalized advice and guidance.

Considerations:

• Short-Term Use: Tramadol is generally recommended for short-term use due to the risk of dependence.
• Consultation: Always consult with your healthcare provider to determine if tramadol is the right option for you and to discuss potential risks and benefits.