Tramadol’s limited relief vs. rising risks prompt a rethink of its use for chronic pain
A BMJ Evidence-Based Medicine review analyzed 19 randomized trials (6,506 participants) and found tramadol provides only modest, likely non-meaningful relief for chronic pain while doubling the risk of harm versus placebo—predominantly heart-related events—with common side effects such as nausea, dizziness, and constipation. Many included studies carried biases that may overstate benefits and understate harms; a questionable signal for cancer risk was noted due to short follow-up. Overall, the potential harms appear to outweigh the limited benefits, underscoring a need to rethink tramadol’s role in chronic-pain care amid broader opioid concerns.
