The painkiller linked to big heart risks and little relief

When my husband injured his back recently, he was in so much pain that he went to the doctor — something he rarely does.

I expected him to come back with a prescription painkiller or maybe a muscle relaxer. Instead, he was sent home with some lidocaine patches and a bottle of over-the-counter acetaminophen (better known as Tylenol). Neither of them relieved his pain.

At first, I was puzzled as to why the doctor hadn’t given him stronger pain medication. But given all I knew about the dangers of certain drugs, I was glad she was so hesitant…

The hidden dangers of tramadol

Take tramadol, for instance. A dual-action opioid prescribed for moderate to severe acute and chronic pain, tramadol is seen as safer and less addictive than other opioids like morphine and oxycodone. That’s why it’s the most frequently prescribed opioid in the U.S.

I had heard this about tramadol, which is why I was surprised the doctor didn’t prescribe it for my husband’s back pain. Then, I dug deeper. What I found was chilling…

A team of Danish researchers wanted to get to the bottom of whether tramadol was truly safe and effective in treating different types of chronic pain. Their final analysis covered 19 trials involving 6,506 participants with an average age of 58.

Five studies focused on neuropathic pain, nine on osteoarthritis, four on chronic low back pain, and one on fibromyalgia. Most studies used tablets, with one testing a topical cream. Treatment periods lasted from two to 16 weeks, with three to 15 weeks of follow-up.

Their analysis was sobering. When the results were combined, the data showed tramadol reduced pain only slightly and not enough for clinically effective relief.

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Even worse, results across eight of the trials linked tramadol to roughly double the risk of harm compared with placebo — largely due to more reported cardiac events such as chest pain, coronary artery disease and congestive heart failure.

Tramadol use was even associated with a higher risk of certain cancers, though the researchers warned that the short follow-up time makes this result “questionable.”

Across all trials, tramadol demonstrated a greater risk of milder side effects such as nausea, dizziness, constipation and sleepiness.

This adds to earlier research that found tramadol increases the risk of hypoglycemia by tenfold.

Given these results, coupled with the increasing trends in opioid-related deaths, the researchers say “the use of tramadol and other opioids should be minimized to the greatest extent possible.

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

Alternative pain relief

So, if tramadol’s benefits are this limited — and its risks this concerning — what other options are worth discussing for chronic pain?

After much trial and error, my husband hit on a couple of non-drug options that significantly reduced his back pain. One was his chiropractor. It took a few visits, but his pain finally started to subside.

This aligns with research showing chiropractic patients experience greater relief from low back pain (56%) than those treated by medical doctors (13%).

The second was transcutaneous electrical nerve stimulation (TENS). A TENS unit delivers low-voltage electrical currents at or near your nerves to block or change your perception of pain. Using this device every evening after dinner relieved enough of my husband’s pain to allow him to sleep through the night.

Most drugstores now sell TENS units, but if you can’t find one there, plenty of options are available online.

Lastly, consider these two supplements to support your body’s natural responses to pain:

• Vitamin D has been shown numerous times to have a modifying effect on pain, including surgical pain. One reason is that it regulates inflammation, a major pain amplifier.
• Omega-3s are essential fatty acids that help support a healthy inflammatory response. Since your body doesn’t make them, they must come from food, like fatty fish, or from supplements. Two key omega-3s are DHA and EPA, and EPA in particular has been studied for its pain-modulating effects.

Now these nutrients can only do their best when your body maintains adequate levels, so don’t wait till you’re hurting. They should be a regular part of a daily regimen.

Sources:

This popular painkiller may do more harm than good — ScienceDaily

Tramadol versus placebo for chronic pain: a systematic review with meta-analysis and trial sequential analysis — BMJ Evidence-Based Medicine

Transcutaneous Electrical Nerve Stimulation (TENS) — Cleveland Clinic

FAQ: What to know about tramadol, pain relief and heart risk