Pain control in thumb osteoarthritis commonly relies on anti-inflammatory therapy. A distinct clinical situation arises when NSAIDs cannot be used — due to contraindications, intolerance, or an insufficient response — and no other viable analgesic alternatives remain.
In this setting, guidelines conditionally address an opioid-class analgesic option for pain relief — the complete protocol details, including conditions of use, are available below.
DOI: 10.1016/j.rdc.2022.03.009.
Recommendations on the use of tramadol were mixed, either conditionally/weakly against or conditionally/weakly for; this variation was primarily related to the recognition that some patients require an option for pain management when oral NSAIDs are not an option (contraindicated, not tolerated, or ineffective), particularly when considering input from patient panels.
Opioids, including tramadol, are generally not recommended, though guidelines did acknowledge that in some cases, such as in instances of contraindications, intolerance to, or inadequate response to NSAIDs, tramadol can be considered for pain relief in the absence of other viable options.
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