Limited benefit of tramadol in osteoarthritis

Based on moderate-quality evidence, tramadol alone or in combination with paracetamol probably had no important benefit over placebo on mean pain intensity (4% absolute improvement) or physical function in people with OA. However, there were slightly more people (5%) in the tramadol group who achieved a clinically important improvement (at least 20%) in pain. Moderate-quality evidence showed that adverse events probably cause substantially more participants to stop taking tramadol. The increase in serious adverse events with tramadol was less certain due to the small number of events. Participants were predominantly women with an average age of 63 and with moderate to severe pain. The length of the studies ranged from 1 week to 3 months.