Tramadol compared with Diclofenac in traumatic musculoskeletal pain

This multicenter, randomized, controlled, open-label trial of 120 patients (89 men, 31 women) was conducted to compare the efficacy and safety of tramadol and diclofenac (both at 200 mg/d) in the short-term treatment (5 to 7 days) of traumatic musculoskeletal pain. Tile posology of the two treatments was 100 mg twice daily; however, the patients could take three doses per day. Patients were randomly assigned to either treatment. Thirty patients, with strong pain resulting from trauma to bones, joints, and/or ligaments, were admitted to each of four centers. The analgesic effect of both drugs was confirmed by the significant reduction in pain compared with baseline. The analgesic activity of tramadol was higher than that of diclofenac, after both the first dose (between treatments at the 5th and 6th hours), and during repeated therapy (between treatments on day 2 and at the end of treatment). Patients' quality of sleep improved significantly with both drugs, on day 2 and at the end of treatment, compared with baseline. Seven patients discontinued the drugs because of moderate-to-severe adverse reactions (4 receiving tramadol and 3 receiving diclofenac). Another 6 patients had moderate-to-mild reactions (4 receiving tramadol and 2 receiving diclofenac). Final assessments of efficacy and safety were all significantly in favor of tramadol.