Nikhil Prasad Fact checked by:Thailand Medical News Team Dec 21, 2025 1 hour, 55 minutes ago
Medical News: A Commonly Prescribed Drug Under Scrutiny
A widely used painkiller once believed to be a safer option for chronic pain is now facing serious scientific scrutiny. Researchers are warning that tramadol, a strong opioid prescribed to millions worldwide, may cause more harm than good. A large review of existing clinical trials has found that the drug offers only minimal pain relief while significantly increasing the risk of dangerous side effects, particularly those affecting the heart.
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A major review finds tramadol offers little pain relief while significantly increasing the risk of serious side
effects including heart problems
The findings come from a comprehensive analysis of previously published studies and were reported by researchers from the Copenhagen Trial Unit at the University of Southern Denmark along with collaborators from several international academic and clinical research institutions. The analysis has raised new concerns about the routine use of tramadol for long term pain conditions.
Why Tramadol Became So Popular
Tramadol is commonly prescribed for moderate to severe pain, including arthritis, back pain, nerve pain, fibromyalgia, and cancer related pain. Over the past decade, its use has surged, especially in the United States, because it was widely perceived as less addictive and safer than other opioids. This perception led many doctors to favor tramadol as a first line or long-term treatment option for chronic pain.
However, despite its popularity, there had never been a broad and detailed assessment of both its effectiveness and safety across multiple chronic pain conditions. This gap prompted researchers to take a closer look at all available high-quality evidence.
What the Researchers Analyzed
The research team reviewed 19 randomized clinical trials involving 6,506 adults suffering from various forms of chronic pain. These included neuropathic pain, osteoarthritis, chronic lower back pain, fibromyalgia, and cancer related pain. Most participants were around 58 years old, and the treatments lasted between two and sixteen weeks.
After pooling and analyzing the data, the researchers found that tramadol did reduce pain scores slightly. However, the improvement was so small that it fell below the level considered meaningful for patients in real life.
Increased Risk of Serious Side Effects
More concerning was the clear increase in harm. Patients taking tramadol were more than twice as likely to experience serious adverse events compared to those given a placebo. Many of these events were related to the heart, including chest pain, coronary artery disease, and heart failure. There was also a signal suggesting a possible increased cancer risk, though researchers cautioned that the follow up period was too short to draw firm conclusions.
In addition, tramadol users experienced common but troublesome side effects such as nausea, dizziness, constipation, and excessive sleepiness. According to this
Medical News
a> report, these side effects occurred frequently enough to disrupt daily life for many patients.
Broader Public Health Concerns
The researchers placed their findings in the wider context of the global opioid crisis. Worldwide, tens of millions of people suffer from opioid dependence, and opioid related deaths have risen sharply in recent years. Given these trends, even drugs perceived as milder opioids deserve careful re-evaluation.
Final Conclusions
The researchers concluded that tramadol provides only a small reduction in chronic pain while clearly increasing the risk of serious and non-serious side effects. They emphasized that the balance between benefit and harm is unfavorable and that tramadol use should be minimized wherever possible. Alternative pain management strategies, including non-drug approaches, should be prioritized to protect patient safety and reduce long term risks.
The study findings were published in the peer reviewed journal: BMJ Evidence-Based Medicine
https://ebm.bmj.com/content/early/2025/09/26/bmjebm-2025-114101
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