Tramadol is a popular painkiller used around the world to treat long-lasting pain, but new research shows it might not work as well as people think—and it could even be harmful.
A recent study published in BMJ Evidence Based Medicine found that tramadol may not ease chronic pain effectively and could increase the risk of serious side effects like heart problems.
Because of this, scientists believe the risks of taking tramadol may be greater than the benefits.
Tramadol is a type of strong pain medicine that acts in two ways. It’s often prescribed for moderate to severe pain, including pain from arthritis, nerve damage, or even cancer. Many doctors choose tramadol because they believe it’s safer and less addictive than other opioids. In the U.S., tramadol is now one of the most prescribed opioids.
Although some reviews have looked at tramadol before, none have fully explored how well it works and how safe it is for people with different kinds of long-term pain.
To find answers, researchers searched medical databases for studies published before February 2025. They looked for trials where people with chronic pain were randomly given either tramadol or a fake pill (placebo).
The researchers found 19 studies with a total of 6,506 patients who had chronic pain. Some studies focused on nerve pain, others on arthritis, back pain, or fibromyalgia. Most of the people in the studies were around 58 years old, and the treatment periods lasted between 2 and 16 weeks.
When all the data were combined, the researchers found that tramadol did reduce pain a little—but not enough to make a real difference in people’s lives. The effect was too small to be considered useful for medical treatment.
More concerning were the side effects. In eight of the studies, researchers tracked serious health problems that happened after taking tramadol.
The results showed that people taking tramadol were twice as likely to have serious side effects compared to those taking the placebo. Many of these were heart problems, such as chest pain, blocked arteries, or heart failure.
There was also a link between tramadol and a higher risk of certain cancers, but this finding is uncertain because the studies didn’t follow people for very long. In addition, people who took tramadol were more likely to experience common side effects like feeling sick, dizzy, tired, or constipated.
The researchers admit that some of the study results could be biased, which means the positive effects might be exaggerated while the negative effects might be downplayed. Still, they warn that tramadol is not as safe as many believe.
They also highlight the growing problem of opioid addiction around the world. About 60 million people are affected by opioid addiction. In 2019, opioids were linked to 600,000 deaths, with nearly 80% of those caused by opioids and a quarter from overdoses. In the U.S. alone, opioid overdose deaths rose from nearly 50,000 in 2019 to over 81,000 in 2022.
Given these numbers and the study findings, the researchers recommend that doctors reduce how often they prescribe tramadol and other opioids. It may be time to rethink how we manage chronic pain, focusing more on treatments that are both safe and effective.
If you care about pain management, please read studies about Scientists find a new drug for chronic nerve pain and findings of Scientists find a new, less-invasive way to tackle knee pain.
If you care about pain, please read studies about Scientists find a new way to manage knee pain and findings of Promising new drug offers hope for chronic nerve pain relief.
The study is published in BMJ Evidence-Based Medicine.
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