Table of Contents
Volume 2013 (2013), Article ID 245346, 16 pages
Review Article

Tramadol Extended-Release for the Management of Pain due to Osteoarthritis

Anesthesiology and Pain Medicine, University of L’Aquila, Viale San Salvatore, Edificio 6, Coppito, 67100 L’Aquila, Italy

Received 11 February 2013; Accepted 29 April 2013

Academic Editors: M. I. Díaz-Reval, G. Krammer, and A. Ulugol

Copyright © 2013 Chiara Angeletti et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Current knowledge on pathogenesis of osteoarticular pain, as well as the consequent several, especially on the gastrointestinal, renal, and cardiovascular systems, side effects of NSAIDs, makes it difficult to perform an optimal management of this mixed typology of pain. This is especially observable in elderly patients, the most frequently affected by osteoarthritis (OA). Tramadol is an analgesic drug, the action of which has a twofold action. It has a weak affinity to mu opioid receptors and, at the same time, can result in inhibition of the reuptake of noradrenaline and serotonin in nociceptorial descending inhibitory control system. These two mechanisms, “opioidergic” and “nonopioidergic,” are the grounds for contrasting certain types of pain that are generally less responsive to opioids, such as neuropathic pain or mixed OA pain. The extended-release formulation of tramadol has good efficacy and tolerability and acts through a dosing schedule that allows a high level of patients compliance to therapies with a good recovery outcome for the patients' functional status.