Common painkiller is ‘not very effective’ AND ‘doubles the risk of heart disease’

A WIDELY prescribed painkiller is not that effective at easing pain, scientists say.

It may also increase the risk of serious side effects, including heart disease, they warn.

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Tramadol is prescribed to treat both acute and chronic pain[/caption]

Tramadol is a strong, prescription-only opiate painkiller that’s used to treat moderate to severe pain, for example after an operation or a serious injury.

It can also be prescribed for long-term pain if weaker painkillers no longer work.

According to the NHS, tramadol won’t stop the pain completely, but it’ll stop you feeling it as much.

Its use has surged in recent years, possibly because it’s thought to be safer and less addictive than other opioid medications and have fewer side effects.

Tramadol is now among the most commonly prescribed opioids in the US, according to researchers from the Centre for Clinical Intervention Research in Denmark.

As for the UK, prescription rules around the drug were tightened due to concerns about misuse, dependence, and harm.

The new study, published in BMJ Evidence Based Medicine, found that it’s not that effective at easing chronic pain, which it’s widely prescribed to treat.

They concluded that the potential harms of tramadol probably outweigh its benefits, warning that its use should be minimised.

Researchers combed through clinical trials published up to February 2025 that compared tramadol with placebo – dummy treatment – in patients with chronic pain, including pain from cancer.

They included nineteen clinical trials involving 6,506 participants with chronic pain.

Five looked at the impact of tramadol on neuropathic pain, which stems from damage to the nervous system.

Nine of the studies focused on osteoarthritis, four looked at chronic lower back pain, and one focused on fibromyalgia – a long-term condition that causes pain all over the body.

Participants were between 47 and 69 years old and most took tramadol in tablet form, for two to 16 weeks.

Studies followed up with the patients three to 15 weeks later.

Data analysis of the trial results showed that while tramadol eased pain, it only did so to small degree and below what would be considered clinically effective.

Eight of the trials tracked serious side effects developing up to 16 weeks after treatment with tramadol.

Researchers’ statistical analysis showed that patients on tramadol faced double the risk of harm compared to those on placebo meds.

A higher rate of ‘cardiac events,’ such as chest pain, coronary artery disease, and congestive heart failure, was recorded among tramadol-takers.

This doesn’t necessarily mean that one caused the other – just that tramadol use and heart disease are linked.

Use of tramadol was also linked to a higher risk of some cancers, although researchers marked this finding as “questionable”, as the follow-up period in the trials was short.

Finally, tramadol treatment was also associated with a higher risk of several milder side effects, including nausea, dizziness, constipation, and sleepiness.

Researchers concluded: “Tramadol may have a slight effect on reducing chronic pain (low certainty of evidence) while likely increasing the risk of both serious (moderate certainty of evidence) and non- serious adverse events (very low certainty of evidence).

“The potential harms associated with tramadol use for pain management likely outweigh its limited benefits.”

The researchers acknowledge that their results had a high risk of bias.

But it was more likely that their findings overestimated the beneficial effects of tramadol and underestimate its harms, they claimed.

They pointed out: “Approximately 60 million individuals worldwide experience the addictive effects of opioids.

“In 2019, drug use was responsible for approximately 600,000 deaths, with nearly 80 per cent of these fatalities associated with opioids and approximately 25 per cent resulting from opioid overdose.

“In the United States, the number of opioid-related overdose deaths increased from 49,860 in 2019 to 81,806 in 2022.

“Given these trends and the present findings, the use of tramadol and other opioids should be minimised to the greatest extent possible.”