| Summary: | Chronic pain is persistent pain, which can be continuous or recurrent and it adversely impacts an individual's wellbeing, and functional ability. Treatment options for chronic pain include pharmacological and non-pharmacologic approaches. Pharmacological options include a variety of drug types such as non-opioid analgesics (acetaminophen, non-steroidal anti-inflammatory drug [NSAID]), opioids, antidepressants, antiepileptic drugs and muscle relaxants. Tramadol is considered a weak opioid due to its relatively low affinity for [mu]-opioid receptor, the main target for traditional opioids. Tramadol and its active metabolite bind to [mu]-opioid receptors in the central nervous system resulting in inhibition of ascending pain pathways and also inhibits the reuptake of norepinephrine and serotonin involved in the descending inhibitory pain pathway associated with pain relief. Tramadol is available in various formulations and also in combination with other drugs such as acetaminophen and paracetamol. There appears to be some concern regarding the place of tramadol in the management of pain in adults. The purpose of this report is to review the clinical effectiveness of tramadol or tramadol combinations for the management of pain in adults
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