Tramadol/Acetaminophen Improves Quality of Life in Chronic Pain Patients


Fibromyalgia patients who were given analgesic in a randomized, double-blind study experienced a reduction in pain and an improvement in health-related quality of life. Before the study, patients experiencing pain had significant impairment of their health-related quality of life, but during the study, the patients’ pain relief directly correlated to an increase in health-related quality of life.

Researchers at Oregon Health and Science University in Portland and collaborators and other institutions were supported by Ortho-McNeil Pharmaceutical, Inc., to conduct the study. The study, entitled, “Impact of Fibromyalgia Pain on Health-Related Quality of Life Before and After Treatment With Tramadol/Acetaminophen,” was published in the journal Arthritis & Rheumatism.

A total of 313 fibromyalgia patients with moderate-to-severe pain were recruited for the study. Patients received tramadol/acetaminophen four times a day, every day, for up to a possible allotment of 91 days. The ratio of tramadol to acetaminophen was 1-to-8. The two medications were selected to be given together because tramadol and acetaminophen work through different mechanisms to achieve the goal of pain relief.

At baseline, patients were evaluated for pain using the visual analog scale (VAS), where no pain is a score of 0 and extreme pain is a score of 100 mm. Patients were grouped into four categories based on pain score and evaluated for differences in outcome measures from the beginning of the study to the end, then compared against each other. The outcome measures included patient ratings on the Short Form 36 Health Survey (SF-36), the Fibromyalgia Impact Questionnaire (FIQ), and the Medical Outcomes Study (MOS) sleep questionnaire.

Overall, the enrolled fibromyalgia patients had a worse SF-36 scale score than the average United States citizen, and their scores were worse than those of congestive heart failure patients. The poor scores, indicative of an impaired health-related quality of life, correlated to the greatest amount of severe pain. When the treatment group of patients took tramadol/acetaminophen, they saw a significant reduction in pain. This led to a significant improvement in health-related quality of life in terms of SF-36 physical function, role physical, bodily pain, and physical summary scales. They were further able to improve their FIQ scales in terms of pain, stiffness, and doing jobs.

“Moderate-to-severe fibromyalgia pain significantly impairs health-related quality of life, and effective pain relief in these patients significantly increases health-related quality of life,” wrote the authors. Clinicians should be aware of their patients’ health-related quality of life and suggest analgesics when appropriate to reduce pain and improve quality of life.