What is the efficacy of Tramadol (tramadol hydrochloride) for pain relief in tension-type headaches?

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Last updated: May 7, 2025View editorial policy

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From the FDA Drug Label

Tramadol hydrochloride has been given in single oral doses of 50,75 and 100 mg to patients with pain following surgical procedures and pain following oral surgery (extraction of impacted molars). In single-dose models of pain following oral surgery, pain relief was demonstrated in some patients at doses of 50 mg and 75 mg Tramadol hydrochloride tablets, USP are indicated for the management of moderate to moderately severe pain in adults.

Tension Headache pain relief with tramadol is not directly addressed in the provided drug labels. The labels discuss pain relief in the context of surgical procedures and oral surgery, as well as the management of moderate to moderately severe pain in adults, but do not specifically mention tension headaches. Therefore, no conclusion can be drawn about the effectiveness of tramadol for tension headache pain relief based on the provided information 1 1.

From the Research

Tramadol should not be the first-line treatment for tension headache pain relief, and instead, over-the-counter options like acetaminophen or NSAIDs should be tried first. According to the most recent and highest quality study 2, paracetamol and ibuprofen showed better efficacy than placebo in treating episodic tension-type headache, with no statistically significant difference in efficacy between the two drugs. For individuals at a higher risk, such as those with renal insufficiency or risk of GI bleeding, paracetamol may be considered as a preferred option instead of ibuprofen.

Key Points to Consider

  • Non-medication approaches, such as stress management, adequate hydration, and regular sleep, should be tried first
  • Over-the-counter options like acetaminophen or NSAIDs are recommended as the first-line treatment
  • Tramadol can be effective for tension headache pain relief when other treatments have failed, but it should be used with caution due to its potential for dependence and side effects
  • The typical dosage of tramadol is 50-100 mg every 4-6 hours as needed, not exceeding 400 mg per day
  • It is essential to consult a healthcare provider before starting tramadol, especially if you have liver or kidney problems, seizure disorders, or are taking other medications that affect serotonin levels.

Important Considerations

  • Tramadol works by binding to opioid receptors and inhibiting the reuptake of serotonin and norepinephrine, which helps block pain signals
  • Tramadol should be taken with food to minimize stomach upset and avoid alcohol, limit use to short periods, and never stop suddenly after prolonged use
  • Other studies 3, 4, 5, 6 also support the use of over-the-counter options like acetaminophen or NSAIDs as the first-line treatment for tension headache pain relief.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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