Study suggests risks outweigh benefits of a widely used prescription painkiller
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- Reviewed by Anthony L. Komaroff, MD, Editor in Chief, Harvard Health Letter; Editorial Advisory Board Member, Harvard Health Publishing
Tramadol is one of the most widely prescribed pain medications in the United States. It’s among the weaker opioid drugs (though still addictive), and it’s often used to treat moderate to severe chronic pain. But an analysis published online Oct. 7, 2025, by BMJ Evidence-Based Medicine found that tramadol isn’t especially effective for chronic pain and has a high rate of side effects. Researchers pooled the results of 19 randomized controlled trials involving a total of more than 6,500 people (average age 58). Participants took either tramadol or a placebo (inactive) pill to ease pain from various conditions, such as arthritis, low back pain, or neuropathy. They took the pills for up to four months and were then followed for up to about four months more, depending on the study. While tramadol was mildly effective, the study authors concluded that its risks likely outweighed its benefits. Risks included serious side effects (such as heart problems) and milder ones (such as constipation, dizziness, and nausea). If tramadol is recommended to you for chronic pain, discuss other options with your doctor.
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About the Author
Heidi Godman, Managing Director
About the Reviewer
Anthony L. Komaroff, MD, Editor in Chief, Harvard Health Letter; Editorial Advisory Board Member, Harvard Health Publishing
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