For patients with osteoarthritis, a degenerative condition of the bones and joint cartilage that causes pain and stiffness, one of the main treatments given is pain relief medication. You may have recently heard of the use of pain medications being referred to as an ‘opioid crisis’, due to the high rate of people who are dying from prescription pain medications.

A cohort study published on March 12, 2019, by Zeng et al (1), found that Tramadol had a significantly higher rate of mortality (death) over 1 year of use compared to naproxen (hazard ratio [HR] 1.71), diclofenac (HR 1.88), celecoxib (HR 1.70) and etoricoxib (HR 2.04). Codeine was found to have a slightly higher mortality rate than the Tramadol.

Due to the study being a cohort, the cause of death is not known, the study just looked at the rate of mortality while taking the medications. Despite not showing a causal link, the mortality rates while taking these medications are concerning and warrant further investigation.

Due to the opioid crisis, many people are looking for alternatives to pain medications, especially now that certain medications have become prescription-only in Australia. Acupuncture is a valid treatment option for osteoarthritis, according to a 2014 systematic review and meta-analysis by Manyanga et al (2).

The study found that the use of acupuncture was associated with “significant reductions in pain intensity, improvement in functional mobility and quality of life”. They also concluded that “current evidence supports the use of acupuncture as an alternative for traditional analgesics in patients with osteoarthritis”.

Please share this article with your friends and family who have osteoarthritis so they can benefit from greater knowledge of their treatment options.



(1) Zeng C, Dubreuil M, LaRochelle MR, et al. Association of Tramadol With All-Cause Mortality Among Patients With Osteoarthritis. JAMA. 2019;321(10):969–982. doi:10.1001/jama.2019.1347

(2) Manyanga T, Froese M, Zarychanski R, et al. Pain management with acupuncture in osteoarthritis: a systematic review and meta-analysis. BMC Complementary Alternative Medicine. 2014;14:312. doi: 10.1186/1472-6882-14-312.