Arthritis greatly affects different parts of the knee, making overall movement difficult and causing you to be less mobile throughout the day. Analgesics like Tramadol are sometimes taken for arthritis relief.

This article will discuss whether tramadol is effective for arthritis pain and more about its potential as a pain relief option.

What is Tramadol?

Tramadol is an opioid medicine that helps relieve moderate to moderately severe pain among adults and children 12 years or older, particularly after a surgical procedure. It belongs to a class of medications called opiate (narcotic) analgesics and works by altering the brain and nervous system response to pain.

Tramadol comes in the form of tablets, a solution (liquid), an extended-release (long-acting) tablet, and an extended-release (long-acting) capsule, with the tablets and capsules being used specifically by people who need medication to relieve pain all at hours.

Benefits and Risks of Using Tramadol for Arthritis

How Tramadol Works for Arthritis

Tramadol is an alternative treatment option for people suffering from knee and hip osteoarthritis who aren’t allowed to take drugs like acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) and who did not experience the desired results or improvements. At the same time, tramadol can also be used with acetaminophen or NSAIDs (with the guidance of your healthcare provider. 

Being an analgesic, tramadol could help relieve pain by binding to opioid receptors in the central nervous system and can inhibit the reuptake of certain neurotransmitters known as norepinephrine and serotonin, which regulate various physiological functions like pain, cognition, and emotions – specifically anxiety and depression.

Scientific Studies and Findings

Studies show that tramadol does show promise in helping treat pain associated with inflammatory arthritis. For example, unlike other pain relievers like NSAIDs, it poses a lesser likelihood of bleeding in the stomach and intestines or kidney problems, nor does it affect the cartilage at the end of the bones. 

Tramadol helps decrease pain intensity, produces symptom relief, and improves function in patients with osteoarthritis, with study participants experiencing a 12% relative decrease in pain intensity after medicating with tramadol and paracetamol.

However, one study showed that osteoarthritis patients who receive tramadol for osteoarthritis demonstrate an increased risk for hip fractures, venous thromboembolism, and mortality compared with those treated with NSAIDs. 

Another study found that medicating on tramadol alone (or in combination with acetaminophen probably) for 3 months showed no significant benefit on mean pain or function in people with osteoarthritis, although a few reported experiencing some improvements.

Possible Side Effects 

Many people using this medication do not have serious side effects, but when they do, side effects have been known to occur, such as:

• Nausea
• Vomiting
• Constipation
• Lightheadedness
• Dizziness
• Drowsiness
• Headaches
• Itching

Some of these side effects may decrease after using this medication. Tell your doctor or pharmacist to have them prescribe you a lower dosage or switch to another medication completely if these effects worsen.

More serious side effects include:

• Sleep apnea
• Mental/mood changes
• Severe stomach/abdominal pain
• Appetite loss
• Fatigue
• Breathing problems
• Difficulty urinating
• Sudden weight loss

These symptoms should be immediately reported and consulted with your healthcare provider.

Precautions

Your doctor may start you on a low dose of tramadol and gradually increase the amount of medication you take, not more often than every 3 days if you take the solution or regular tablets or every 5 days if you take the extended-release tablets or extended-release capsules.

For (extended-release) tablets/capsules

Do not stop your tramadol medication instantaneously. Consult your doctor first to have your doses decreased gradually. Otherwise, you may experience withdrawal symptoms such as nervousness, panic, sweating, difficulty falling asleep or staying asleep, runny nose, sneezing, cough, and pain.

Take the extended-release tablet/capsule at about the same time every day. If you are taking the extended-release tablet or capsule, you should take it consistently, always with or without food. Take tramadol exactly as directed.

For liquid solution

If you are taking the solution, use an oral syringe or a measuring spoon/cup to measure the correct amount of liquid needed for each dose. Do not use a regular household spoon to measure your dose. 

Do not take more medication as a single or daily dose than your doctor prescribes. Taking more tramadol than your doctor prescribes or in a way that is not recommended may cause serious side effects or death.

Dosage Tips

The most typical RDA for tramadol is 50 to 100 mg every 4 to 6 hours as needed, not exceeding 400 mg daily for people aged 18-65. Children often have a much lower dosage set by pediatricians.

Eat dietary fiber, drink enough water, and exercise to prevent constipation and other side effects. To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position after taking the supplement.

Who Shouldn’t Take Tramadol

Avoid taking tramadol if you are allergic to it or have severe asthma, breathing problems, and stomach or bowel problems. Tramadol should not given to anyone younger than 12 years old and those younger than 18 who have recently undergone surgery to remove the tonsils or adenoids.

Before taking tramadol, you should tell your doctor if you’ve had any of the following:

• Breathing problems
• Sleep apnea;
• Liver or kidney disease;
• Urination problems
• Gallbladder, pancreas, or thyroid problems
• Gastrointestinal issues
• History of mental illness or have had prior suicide attempt(s)

Alternatives to Tramadol for Arthritis Pain

There are various alternatives to tramadol that might be considered for arthritis pain. The appropriate choice usually depends on the type, location, and severity of arthritis, as well as the patient’s age, overall health, and other concurrent medications and health conditions.

Some potential alternatives include:

Over-the-counter (OTC) & Other Prescription Pain Relievers

Over-the-counter pain relievers and prescription drugs such as ibuprofen (Advil), acetaminophen (Tylenol), naproxen (Aleve), and duloxetine (Cymbalta) have been effective for people who have mild to moderate flare-ups of knee pain. Other drugs like meloxicam (Mobic), oxaprozin (Daypro), and piroxicam (Feldene) are also frequently prescribed.

Many studies also show that pairing NSAIDs, COX-2 inhibitors, and analgesics helps improve pain and physical function in knee/hip osteoarthritis patients. One clinical trial showed that OTC medications help provide moderate and clinically meaningful pain relief and function in patients with short-term hand, hip, or knee osteoarthritis.

Topical creams also help relieve arthritis-related pain. Capsaicin cream, for example,  is a safe and highly effective treatment for arthritis. Diclofenac-based topicals are also shown to be effective in pain management.  

Non-Medicinal Therapies

The RICE Method

The RICE method stands for Rest, Ice, Compression, and Elevation. It’s a self-care technique that helps reduce swelling, relieve pain, and speed healing and is often applied as an immediate treatment for minor injuries.

For arthritis pain, it can be done like this:

• Rest – Get adequate rest after experiencing pain. As much as possible, avoid intense physical activities that can trigger arthritis pain and other symptoms. 
• Ice – Put an ice pack over the affected joint(s) several times daily for up to 20 minutes. Avoid applying the ice directly.
• Compression – Wrap the joint firmly with a bandage or compression sleeve. The compression reduces swelling and tension around the injury and helps speed healing.
• Elevation – Elevate the affected body part above the level of your heart to decrease swelling and joint pain.

Seek immediate medical care if pain and other symptoms persist or worsen. 

Healthy Diet And Weight Management

Eating a healthy diet helps prevent unwanted weight gain and reduces the effects of osteoarthritis. Studies show that foods rich in excess fats, sugars, grains, and other carbohydrates result in unhealthy weight gain, which increases the risk of the body lapsing into an inflammatory state and adding pressure to the joints. An unhealthy diet can also upset the gut microbiome balance, trigger the inflammatory process, and cause symptoms. 

Dietitians often recommend observing a Mediterranean diet consisting of omega-3-rich fish like salmon or sardines, legumes, whole grains, nuts, dairy, garlic, fruits, and dark leafy greens to combat the effects of arthritis, strengthen bones, and reduce the risk of fractures.

Regular Exercise

Regular, low-impact exercise relieves arthritis joint pain and stiffness. Low-impact cardio exercises like walking, swimming, biking, tai chi, and yoga keep the heart and lungs strong. Resistance exercises like pushups and lunges use your weight to strengthen muscles and support your joints. 

Stretching exercises can also help improve flexibility and ease arthritis joint pain and stiffness.

*If unsure which works best, check with your doctor or a physical therapist for a personalized exercise plan.

Acupuncture

Many people recourse to acupuncture for pain relief, especially for arthritis pain. A recent study found it effective on pain, disability, and quality of life in people with people with rheumatoid arthritis in the hand. 

Acupuncture stimulates endorphins, serotonin, dopamine, and oxytocin, the body’s natural painkillers and neurotransmitters, stimulating nerve and energy pathways to boost blood flow and brain activity.

Stress Management

Studies show that relaxation techniques such as deep breathing, yoga, meditation, tai chi, exercise, and prayer can mitigate joint tension. Sitting quietly for a few minutes and deep breathing can make your body calmer. 

The body’s stress response fires up the immune system’s inflammatory response when under stress. Here, breathing is more strained, the heart rate speeds up, and the muscle tension increases. 

FAQs

Conclusion

Tramadol is a highly potent opiate analgesic that can provide moderate relief among patients suffering from arthritis. However, based on various studies mentioned above, other medications or prescription drugs may be safer and more effective than tramadol for arthritis.  

Considering its potency and risky side effects, it’s highly important to consult your trusted doctor/healthcare professionals before further medicating with tramadol to see if it suits you best or get more treatment options to better facilitate arthritis pain relief.