Tramadol is a cyclohexanol derivative with mu-agonist activity. It has been used as an analgesic for postoperative or chronic pain since the late 1970s, and became one of the most popular analgesics of its class in Germany. International interest has been renewed during the past few years, when it was discovered that tramadol not only acts on opioid receptors, but also inhibits serotonin (5-hydroxytryptamine; 5-HT) and noradrenaline (norepinephrine) reuptake. This review aims to provide a risk-benefit assessment of tramadol in the management of acute and chronic pain syndromes.

Tramadol has been used intraoperatively as part of balanced anaesthesia. Such use is under discussion, however, as it was associated with a high incidence of intraoperative recall and dreaming, and postoperative respiratory depression has been described after intraoperative administration of high doses. Postoperatively, intravenous and intramuscular tramadol has been used with good efficacy. Analgesic doses were comparable with pethidine (meperidine) and 10 times higher than morphine. Nausea and vomiting were the most frequently reported adverse effects.

In controlled studies, haemodynamic and respiratory parameters were only minimally impaired. The risk of severe respiratory depression in typical dosages is negligible in comparison with other opioids used for postoperative pain management. Tramadol has been used with good results for the management of labour pain without respiratory depression of the neonate. It was also effective for the treatment of pain from myocardial ischaemia, ureteric colic and acute trauma. Good results have been published for cancer pain management with tramadol in several studies.

The potential for abuse or addiction seems to be minimal, and serious complications have not been reported. For patients with severe pain, the efficacy of morphine is superior, and most patients with adequate analgesia from tramadol had to be changed to a more potent opioid after a few weeks due to increased nociceptive input during tumour progression.

Tramadol can be recommended as a safe and efficient drug for step II according to the World Health Organization guidelines for cancer pain management.

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Sometimes the name of an academic periodical is just so “right” it needs no further explanation. In this case, we are interested in the August issue of Pain. Told you so! Anyway, Boston University has been researching the number of people in the U.S. who take opioid painkillers including Ultram. Their results show a higher rate of usage than found in earlier studies. This may be explained by differences in research methods or a change in the honesty of those surveyed or the actual usage may have increased. As it is, the random telephone survey of more than 19,000 adults finds that more than 4m Americans regularly take opioids. In any given week, some 10m adults are likely to take a strong painkiller. This implies that a significant percentage of the adult population believes it suffers from chronic pain of sufficient intensity to justify using one of the stronger painkillers. It is hard to say which is the more worrying. That so many people think they have serious pain, or that so many people routinely rely on opioids to control their pain. The other inference may be that many people are actually abusing their painkillers. It is entirely possible that the true level of opioid abuse is underreported because it is illegal to obtain the drugs without a prescription. Whatever the level of abuse, the survey finds that the symptoms treated were mainly classified as headache, back pain, arthritis, and so on. Only about 5% admitted to using ultram or one of the other painkillers for anxiety or a condition not directly related to physical pain. It is also significant that people taking painkillers were more likely to be taking other medications. It is not surprising that painkillers should be combined with anti-inflammatories, but it is of some concern that some 30% were also taking antidepressants and more than 25% were taking anticonvulsants. There is also evidence of a link to cardiovascular disease and other chronic conditions. It seems probable that those with such problems find pain more of a problem and so take an opioid. The researchers conclude that, although there is an obvious place for opioids like ultram, there is a general need to put more effective pain management services in place to reduce the incidence of abuse.



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A tension headache can be debilitating and we all know what it is like to rummage through the medicine cabinet in search of pain relief for tension headaches, unfortunately these do not always seem to work. As we have been told in so many circumstances, ‘prevention is better than cure’. Well, to prevent a tension headache we need to understand what makes them occur and perhaps we will be able to reduce the number of times we have to resort to pain relief.

During periods of our lives we require pain relief from tension headaches. Sometimes these headaches can last intermittently for weeks, and taking continuous medication is probably not the best solution. A tension headache is rarely in just one place, it usually spreads from behinds the eyes, around the forehead and temples, down the neck and into the shoulders. Finding pain relief for tension headaches is hard enough, but to find relief from all the other related symptoms is even harder. One of the most effective forms of relief for tension headaches is some fresh air, bearing in mind that these headaches are often triggered by environmental and social situations it makes sense that by changing scenery and going to a calm place that you will find some relief. This does not have to be jumping on a plane to a desert island, simply removing yourself perhaps from the study or kitchen and having a couple of minutes quiet time in the garden or living room.

Sometimes fresh air will not offer relief for tension headaches, especially if these are caused by your body already fighting against a viral illness. In these situations it is best to take a mild pain relief for tension headaches and then having rest to help get over the virus. The headache may by your bodies cry for rest. If you cannot find relief for your tension headache or any other pains which you think may be associated then you should visit your general practitioner for further advice.

If you are regularly suffering from tension headaches you should try to work out the triggers for these. Knowing your personal triggers for headaches will help you to manage your pain relief for tension headaches. You will always know your body better than anyone else, however, in our busy lives it is easy to forget to listen to our bodies. If you are going through a patch of suffering badly from headaches it is definitely worth taking note of when these occur and if there are any consistently recurring factors.

It is believed that dehydration can lead to headaches, so if you are prone to tension headaches it is worth ensuring that you are drinking plenty of water as this may reduce the amount of medication you will need to manage your pain relief for tension headaches.

At the end of the day, most tension headaches are caused by the stressful way in which we lead our lives. Unfortunately we cannot easily take a break and have time to ourselves, but it is always worth trying to have some quiet time.



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Tramadol has been used as an analgesic since the late 1970s, and became one of the most popular analgesics of its class in Germany. The international appeal of the drug was renewed his tramadol was discovered that not only acts as the opiates, but also inhibits the reuptake of serotonin and norepinephrine.

Mechanism of action

Tramadol is a unique product. Its mode of action and safety profile distinguishes it from other opioids. It is classified as a centrally acting analgesic atypical and non-opioid and opioid properties. Tramadol is a synthetic analogue of codeine, which has a weak opioid agonist properties. It also inhibits the neuronal reuptake of norepinephrine and serotonin as antidepressants

Tramadol has strong structural similarities to the antidepressant venlafaxine. Because of its similarities to venlafaxine, tramadol May possibly exercise some degree of antidepressant effect in some patients, particularly those suffering from chronic pain.

Side effects

Tramadol is generally well tolerated, the most common side effects are nausea and vomiting. Unlike agents such as morphine and pethidine, respiratory depression rarely occurs during tramadol to equipotent doses of treatment. But high doses of tramadol in May increased the respiratory system, the effects of other drugs. It is also associated with a low incidence of cardiac depression and significantly less dizziness and drowsiness than morphine.

Finally, the potential for abuse and dependence is relatively low because it has only a weak opioid. The low abuse potential of tramadol has been shown by data from post-marketing surveillance.

Tramadol appears to have the same risk of urinary tract (difficulty urinating, urinary retention) than other opiates.

The drug should be avoided in people with epilepsy and used with caution in those taking drugs that lower the threshold for seizures.

Tramadol uses

It is effective in different types of moderate to severe pain, including neuropathic pain. This drug has a dose-dependent efficacy that lies between that of codeine and morphine, with a parenteral power comparable to that of pethidine.

Comparative studies have shown that tramadol is more effective than NSAIDs for controlling post-operative pain. Moreover, as the mode of action of tramadol does not overlap with that of NSAIDs, it is an agent to be combined with these drugs. Using a combination of tramadol and NSAIDs allows the tramadol dose reduced and results in a lower incidence of side effects.

Tramadol May be particularly useful for elderly people suffering from osteoarthritis because, unlike NSAIDs, it does not aggravate hypertension and cardiovascular complications, has not the potential to cause peptic ulcers.

Tramadol has been used successfully to manage labor pain without respiratory depression in the newborn. It is effective for the treatment of pain of myocardial ischemia, renal colic and acute trauma.



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Many doctors and physicians put the phrase chronic pain treatment and Ultram in the same sentence because this medicine is now one of the most popular choices for those in chronic and crippling pain. While not treating or curing any disease, when it comes to chronic pain treatment, Ultram is affording patients a great deal of relief from their arthritis or joint pain, and many other causes of pain as well.

How it Works

For chronic pain treatment, Ultram is not a cure for a disease or condition. It does not treat or address the arthritis or back problems that give people chronic pain. What it does is cut off the receptors in the body that translate nerve signals and impulses as pain. It numbs or eases these receptors.

As an example, think of when you put ice on a sore or cut. The ice numbs the nerves at the skin’s surface so that they no longer feel the pain from the injury. Your sore or cut is not being treated or cured with this ice, you simply can’t feel the pain that you should be feeling because of it.

With chronic pain treatment, Ultram works much the same way. It simply numbs the nerve endings so the body does not register that pain any longer. It will not cure your arthritis or your degenerated disk in your back or any other condition that is causing your chronic and constant pain.

Side Effects

When considering whether or not this is the best medication for you personally, it’s important to consider the possible side effects when addressing chronic pain treatment with Ultram. There are many potential side effects to this medicine, including dizziness, numbness, change in mood, sleepiness but with an inability to get to sleep and stay asleep, nervousness and agitation, muscle tightness, and uncontrolled shaking in some parts of the body. However, these side effects are typically rare and mild and most who have them report that they are not going to let them stop taking the medication.

When it comes to chronic pain treatment, Ultram seems to be the best for most patients and is quickly becoming the most prescribed by doctors everywhere. It is strong enough to treat most cases of pain whether it’s from arthritis or another condition and has side effects that seem to be mostly mild and very manageable. While there are of course some concerns and considerations with this chronic pain treatment, Ultram is the choice preferred by most.

For more information from Bill Johnson about Ultram and pain relief please check http://www.ultramhome.com/pain-relief.html



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