Tramadol painkiller: New study reveals significant heart risks and limited efficacy

A commonly prescribed painkiller, tramadol, may not be as safe or effective as previously thought, according to a recent study published in 'BMJ Evidence-Based Medicine'. The research indicates that while tramadol is widely used for pain management, it offers limited relief and could significantly raise the risk of heart problems, particularly with long-term use. Experts warn that the potential risks may outweigh the benefits for many patients.

The study analysed 19 clinical trials involving 6,506 participants, with an average age of 58, who took tramadol tablets for 2 to 16 weeks to treat chronic pain from conditions such as fibromyalgia, osteoarthritis, nerve damage, and low back pain. Results showed that tramadol provided only minor pain relief, below levels considered clinically meaningful.

More concerning, participants using tramadol had twice the risk of major side effects compared with placebo, largely due to increased cardiac issues, including chest pain, coronary artery disease, and heart failure. Common mild side effects included nausea, dizziness, constipation, and drowsiness. Researchers concluded that the heart-related risks could outweigh the limited benefits of tramadol.

Chronic pain affects around 51.6 million adults in the US, roughly one in five, according to the Centres for Disease Control and Prevention (CDC). For 17.1 million of these adults, pain significantly disrupts work and daily life. Tramadol has been widely prescribed to manage this discomfort, with 16 million prescriptions for the short-acting opioid issued in 2023 alone.

Although tramadol is often considered a “safer alternative” to stronger opioids, with a lower risk of addiction and fewer side effects, the study suggests that patients may need to reassess its use and consider safer, more effective options.