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Spilled Rx pill bottle and Rx tablets: Is tramadol a NSAID?
Drug Info

Does tramadol help with inflammation?

While tramadol can be taken alongside anti-inflammatory medications, it does not possess known anti-inflammatory properties
Wendy Wisner
By | Jun. 11, 2024 Medically reviewed by Abhijeet Danve, MBBS, MD, MHS

Key takeaways

  • Tramadol is a medication used to treat moderate to severe pain.

  • Tramadol can be used for conditions such as nerve pain, cancer pain, postoperative pain, or pain from injuries

  • Although tramadol can be taken along with anti-inflammatory medication, it does not have known anti-inflammatory properties

  • Tramadol is not an NSAID; it is an opioid analgesic drug

In this article:

Pain in the body often goes hand in hand with inflammation. That’s why many people are looking for a medication that can knock out both pain and inflammation at the same time. Tramadol is a well-known, powerful pain medication. But does tramadol help with inflammation? Tramadol isn’t an anti-inflammatory but can be combined with NSAIDs to address both pain and inflammation. 

Is tramadol an anti-inflammatory drug?

Tramadol is not classified as an anti-inflammatory drug. “While tramadol is indicated as a second-line agent for pain management, it does not possess anti-inflammatory properties,” says Reema Hammoud Pharm.D., BCPS, AVP Clinical Pharmacy at Sedgwick. As such, while it’s useful for managing pain, tramadol is not used for inflammation, and it’s not for use in pain conditions where inflammation is the primary concern, Hammoud says.

A 2018 paper published in the Journal of Pharmacology & Clinical Toxicology reviewed data on tramadol to explore if it has anti-inflammatory properties. Researchers reviewed all available data and concluded that there is no evidence of any noteworthy anti-inflammatory effects of tramadol.

Tramadol is sold under the brand names Ultram, Ultram ER, and Conzip, and also in generic form. In 2014, the U.S. Food and Drug Administration (FDA) approved it to treat cases of moderate to severe pain. Tramadol is often prescribed by healthcare providers to treat advanced cancer pain, postoperative pain, trauma, and intractable pain caused by disease, according to Dr. Thomas Pontinen, a double-board certified anesthesiologist and pain management specialist.

Tramadol is a potent pain reliever and is prescribed when people aren’t experiencing relief from first-line pain treatments, notes Leia Rispoli, MD, a double-board-certified interventional pain management specialist and physiatrist at DISC Sports & Spine Center. “Typically, tramadol is used for acute pain that is severe and may involve a neuropathic source, meaning a pain that may be derived from a nerve pain,” Dr. Rispoli states.

For the management of pain with inflammation, non-steroidal anti-inflammatory drugs (NSAIDs) are usually the first-line agents, says Hammoud. NSAIDs are available as both a prescription (in higher strengths) and over-the-counter. While tramadol isn’t an NSAID, it can be taken with one. “Tramadol is safe to be taken together with standard anti-inflammatory medications such as NSAIDs,” says Dr. Pontinen.

Is tramadol an NSAID? 

Many people wonder if tramadol is an NSAID. The answer is that tramadol is not an NSAID. Tramadol is classified as an opioid analgesic. It is classified as a Schedule IV controlled substance, according to the Controlled Substances Act. This means that it has a low risk of addiction compared to other controlled substances, but it still has the potential to be addictive and misused.

Tramadol works by changing how the nervous system and brain respond to pain in the body. “Tramadol is an opioid—a potent painkiller that produces its analgesic effect by blocking nociceptive afferent neurons and the release of neurotransmitters that cause nociception such as substance P and glutamate,” explains Dr. Pontinen.

Tramadol is not similar to anti-inflammatory drugs or NSAIDs in terms of mechanism of action because “There are different mechanisms of action that work by binding to opioid receptors,” Dr. Rispoli says. “There’s also a component of tramadol that is an SNRI, a serotonin-norepinephrine reuptake inhibitor, which means that it increases the level of serotonin and norepinephrine in the brain and may have a role in helping with some of the nerve pain that we discussed earlier,” notes Dr. Rispoli.

So what are NSAID drugs, then? NSAIDs are a group of medicines called anti-inflammatory drugs. They can be used to treat fever, inflammation, and pain. Conditions frequently treated by NSAIDs include muscle pain, sore throat, menstrual pain, arthritis pain, gout, and migraines. NSAIDs work by “inhibiting cyclooxygenase (COX), the enzyme that produces prostaglandins,” Dr. Pontinen explains. “Two involved COX isoenzymes produce prostaglandins that have antagonistic (pain-relieving) effects on the body.”

Examples of commonly used NSAIDs include:

What are the best medications for inflammation?

Individuals experiencing pain and inflammation associated with chronic conditions like arthritis, gout, or colitis may seek anti-inflammatory medications to manage their symptoms. While there are many anti-inflammation medications on the market, the best medication is the one that works for you and is recommended by your healthcare provider. The most common medications for inflammation include NSAIDs and steroids.

Prescription anti-inflammatories (NSAIDs)

Prescription anti-inflammatory drugs must be prescribed by a physician. These drugs are usually more potent and cause more side effects than over-the-counter anti-inflammatories. In most cases, both brand and generic versions of these drugs are available. However, generic versions tend to be less expensive than prescription drugs. Follow your doctor’s guidance for prescribed anti-inflammatories and start with the lowest effective dose.

Here are some anti-inflammatories available by prescription:

  • Naprosyn (naproxen)
  • Celebrex (celecoxib)
  • Ponstel (mefenamic acid)
  • Acular (ketorolac tromethamine)
  • Anaprox (naproxen sodium)
  • Clinoril (sulindac)
  • Daypro (oxaprozin)
  • Feldene (piroxicam)
  • Nalfon (fenoprofen calcium)
  • Voltaren (diclofenac sodium)
  • Indocin (indomethacin)
  • Mobic (meloxicam)
  • Ocufen (flurbiprofen)

Best OTC anti-inflammatory medications (NSAIDs)

There are many over-the-counter anti-inflammatory medications you can purchase. Even though you don’t need a prescription from a doctor to buy these drugs, it’s always best to talk to your healthcare provider before taking any medication. Make sure to follow the instructions in the provided drug information included on the medication bottle carefully, and don’t take more medication than the instructions suggest. Follow any boxed warning on the medication and seek medical attention immediately if any signs of an allergic reaction or drug interaction occur.

Other over-the-counter anti-inflammatory medications to consider include:

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