Views on Tramadol for chronic back pain.

Hi

My back has been really playing up and had to call the doctor out yesterday as I could not move without intense pain in my lower back to the point I was sick.

I have been taking Co Codomol 30/500 for the pain but they were not helping and my doctor has changed me to Tramadol 50mg which he said was a stronger pain killer. They have helped with the pain a little but not completely I was just wondering what others views on this medication were? And have you found it a good pain killer?

Hibee

Ps I also take lyrica for anxiety but found out that it can also help for pain.

  Good morninmg Hibee!

       I have tried the tramadol shortly after my fusion surgery back in 2010, but had little success with it. The success rate here on the CP forum is rather mixed...but we do see members doing well with it. As you know everyone is different so you may expect a mix bag of comments on it.

      Sorry I'm of little help here, but at least this will bump up your thread for you.

    Take care,

     SE

Hi Hibee,

I've been using tramadol (mostly in the ER form as Ultram) since 2007. Until recently, I found it effective for my hip problems and o.k. for my back pain. I started with the IR in 2006, then moved to 200mg daily in the ER form the next year. A few years later, I moved up to 300mg.

It has multiple mechanisms of action: opioid receptor, NMDA receptor and Serotonin release. Because of the latter, it is also prescribed off-label for depression. Personally, I think it was helpful for my mood if not my energy for the better part of 5 years (though I hope to be off it very soon, as I think it has finally come to be inadequate for pain and no longer affecting my mood or energy).

We're all different, but I for one really did benefit from it for about 5 years.

I take Tramadol during intense backache.  It helps though but not for my wrist tendinitis, doesn't touch at all.

Thanks for the information guys

Hibee

Hi bkm

Welcome to the forum. Lyrica is often prescribed for severe pain I take it myself but for other reasons (Anxiety) I don't really no much else about different types of pain killers but I assume anything morphine based will be the best for pain but doctors are often reluctant to prescribe them.

Hibee

Hi Snowbunny21


Thanks for your reply and advice I am going to give it a good try my doctor was talking about referring me to a pain clinic at my last visit so will need to talk to him about that as the pain has got worse since my last visit.

Thanks again

Hibee

Personally, I feel Nucynta (tapentadol) is a similiar but superior medication. Its basically modelled closely to the m1 metabolite of tramadol, so its stronger than tramadol in narcotic action but weaker than the other C-IIs like oxycodone and morphine so it causes less sedation. Like tramadol, its essentially also an SNRI, but has NRI properties more potent than tramadol, but SRI properties weaker than tramadol. Therefore its usually classified as an MOR + NRI centrally acting anaglesic. Its a C-II, so despite having reduced abuse liability and the fact that it builds tolerance considerably more slowly than morphine and oxycodone, its tightly regulated.

As for tramadol, I do feel it is good for moderate nerver related pain......and tapendadol is basically a single step up and can treat up to moderate severe pain. BOTH have limitations due to low opioid actions and SNRI affects (therefore higher doses have unpleasant side effects), but both also have less gastro effects too.

For me personally, both will help with the pain but tramadol seems to have more sedation, possibly due to its stronger SRI effects.

Hibee

I am glad your pain is improving, at least a little.

My mental health nurse introduced me to mindfulness a few months ago, just before my last surgery. I have to admit that initially I thought she had lost the plot but i was so wrong. She had only just finished the practitioners course and was 'trying it out' on me but I have to say the results have been good. I have had depression problems for a while and was prescribed escitalopram which has helped enormously, gave me my life back. But the mindfulness helps with the anxiety and when pain is bad. I am not good at 'letting go' but I have found that with mindfulness it is about living in the moment and I have found I can do that. Let me know how you go, I hope it helps you as much as it helps me.

Good luck

Jane

Glad I could be of some help Hibee.

It really comes down to what works for the individual. I'm enthusiastic about Nucynta because for me personally, it seems to have the least consequences, tolerable side effects (except at break through dosing), and works better than the C-IIIs in treating pain. It doesn't carry the tolerance building risks and has a lower risk for abuse than the other C-IIs (originally, it was supposed to be a C-III due to clinical trails showing limited abuse; but because its not mixed with asprin and has a suposed "likability" factor similiar to hydromorphone, its was required to be released as a C-II).

The downside is of course its newer and though it appears safer than some narcotics, synthetics are still a relatively new area in pain management, so we don't really know what the long term affects are.

One note about tramadol specifically. Tramadol has a long half life, roughly 6 hours. By comparison, Nucynta has about 4 hours half life and oxycodone has 3.5. Therefore, with tramadol, it tends to work better on repeated doses since its metabolites "linger". Its theraputic but no doubt, but you have to becareful to have that occasional window to allow tramadol to be cleared from the body so that toxicity doesn't build up. Although only a fraction of tramadol turns into the m1 metabolite, said metabolite has a half life of 9 hours.

Just my humble opinion. Best to ofcourse discuss this with your doctor and PMD :)