Tramadol is an opiod medication that’s used for treating moderate to severe pain. Unlike non-steroidal anti-inflammatory drugs (NSAIDS), Tramadol does not cause renal (kidney) problems or produce gastric bleeding.

It also has no effect on articular or joint cartilage.  However, Tramadol is a NARCOTIC-LIKE pain reliever, so it should not be used by people who have a history of drug or alcohol dependency or abuse.


A recent meta-analysis (Cepeda et al, 2007), which included 11 individual randomized controlled trials, concluded:

“Tramadol or tramadol/paracetamol decreases pain intensity, produces symptom relief, and improves function in patients with osteoarthritis (OA), but these benefits are small.”


Acetaminophen is generally regarded as one of the first-line medications for osteoarthritis since it has a generally favorable side effect profile. However, acetaminophen can cause liver damage when used in large doses or when used with alcohol.

NSAIDS or non-steroidal anti-inflammatory drugs are also commonly used to treat OA and are generally more effective than acetaminophen at treating arthritis pain (See the previous meta-analysis comparing both drugs). Opioids such as Tramadol are NOT first-line treatments for OA. Opioids should generally be avoided due to their risk of tolerance, dependency, and withdrawal.

They may, however, be an option for people who have tried other conventional treatments and not found adequate pain relief.

Always talk to your health care professional about all treatment options, risks, and side effects.

Additionally, considering that the benefits of Tramadol therapy are relatively small, while the risks of long-term use of opioids are unfavorable, opioids are not likely to be considered a popular treatment option.


  1. Cepeda MS, Camargo F, Zea C, Valencia L. Tramadol for osteoarthritis: a systematic review and meta-analysis. J Rheumatol. 2007 Mar;34(3):543-55.

Written by 

Dr. Jarret Morrow, MD CCFP, is a licensed family physician currently practising in Edmonton, AB. He has a declared special interest in cosmetic dermatology.

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