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Hi, I wondered if it's true that tramadol works better if you take paracetamol as well? I was told this by someone who was told while in hospital but no one has ever said this to me. Also if it is true, would it be the same if it's 12 hour slow release tramadol?
Thanks Jo Cooper

Tramadol and paracetamol are types of painkiller that work in different ways. After surgery tramadol can sometimes be a useful painkiller but it is not recommended for long term non-cancer pain.There is no evidence that drugs containing both paracetamol and tramadol are more effective or safer than separate paracetamol plus codeine, and most prescribing groups in the UK are no longer recommending this combination. Combination paracetamol and tramadol can increase the risk of paracetamol overdose if paracetamol is being taken separately, plus tramadol which is a weak opioid, can be addictive and lead to withdrawal symptoms if suddenly stopped. If you are still in pain in spite of taking slow release tramadol, it should be stopped gradually with the support of your healthcare professionals, as clearly it is not working, it is addictive and can have many serious side effects. If you have not tried pain management or self-management strategies to deal with your pain, it would be worth exploring these options too.

Wendy
Dr Wendy Holden
Medical Advisor to Arthritis Action and Consultant Rheumatologist

Arthritis Action
56 Buckingham Gate London SW1E 6AE
0203 3781 7120 http://www.arthritisaction.org.uk

Thank you for your reply. It was very helpful. I wondered what in your opinion would be a better pain relief medication to take longer term?
Joanna Cooper

Hello,
Unfortunately there are no magic pills that will help all pain for all people. People with chronic pain can have changes in the brain and spinal cord that make painkillers less effective, and sometimes make lifestyle choices that make pain management more challenging. I see that you are awake during the night which can be a problem in itself. If you haven't tried self-management techniques to hope you cope better with pain then these are definitely worth pursuing. Techniques include gentle exercise, weight management, relaxation, meditation and distraction, working on sleep management, and dealing with anxiety and low mood, perhaps with talking therapies such as cognitive behavioural therapy. Pain management programmes that are available in most hospitals cover these topics, but there is also a lot of information on pain self-management online. I hope that helps.

Wendy
Dr Wendy Holden
Medical Advisor to Arthritis Action and Consultant Rheumatologist

Arthritis Action
56 Buckingham Gate London SW1E 6AE
0203 3781 7120 http://www.arthritisaction.org.uk