Published on 29 August 2022

Can You Use Tapentadol For Back Pain?

Tapentadol tapentadol-for-backpain
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Our back is a complex structure of joints, bones, ligaments, and muscles. A person can strain muscles, sprain ligaments, irritate joints, and rupture disks, all of which can lead to back pain. In addition, obesity, poor posture, arthritis, and psychological stress can cause or complicate back pain. 

Back pain is the leading factor of disability worldwide, preventing many people from engaging in work and other everyday activities. It affects people of all ages, from adolescents to older people. Experts estimate that up to 80% of the population will sometimes experience back pain. People living with disability caused by low back pain worldwide increased by 54% between 1990 and 2015.

Low back pain costs Americans at least $50 billion in health care costs each year. Most people suffering from low back pain recover. However, its relapse is usual, and the condition will become chronic and disabling for a smaller percentage of people.

For patients with back pain, Tapentadol may be an appropriate option. In this section, let us discuss in detail the role of Tapentadol in treating back pain.

What Is Tapentadol?

Tapentadol is a novel opioid analgesic belonging to the class of centrally-acting drugs. The analgesic effect of the medication is from its combined effects of agonistic activity. Also, research has supported the role of Tapentadol as one of the most versatile pain medications to help manage moderate-to-severe pain in users.

Other Uses Of Tapentadol

Tapentadol is an oral opioid analgesic that acts as an agonist of the µ-opioid receptor and a norepinephrine reuptake inhibitor for treating moderate to severe acute pain.
Tapentadol is highly effective in the following conditions-

In patients with chronic pain from Fibromyalgia, the increase in inhibition of endogenous pain by Tapentadol was translated into analgesia in patients with a normal CNFS.

This medicine is unsafe for pregnant or breastfeeding women and should inform the healthcare practitioner. 

Mechanism Of Tapentadol

The unique dual mechanism of the opioid analgesic (i.e., noradrenaline reuptake inhibitor and opioid agonist activity) contributes to reducing acute and chronic pain. It also reduces the risk of drug interaction and side effects, and its multimodal functioning makes Tapentadol one of the most sought-after opioid medications on the market.

Tapentadol has a risk of addiction, medicinal misuse, and potential illegal diversion. On 22 June 2009, the Drug Enforcement Agency (DEA) in the United States approved the proposal to make Tapentadol a Schedule II controlled drug Act. So you cannot buy Tapentadol from a local drug store or an online pharmacy without a prescription.

Frequently Asked Questions

It belongs to a class of drugs known as opioid analgesics. Tapentadol helps to relieve moderate to severe short-term pain (such as pain from an injury or after surgery).
As a central nervous system depressant, Tapentadol might lower a person's heart rate and breathing. Extreme sleepiness, sweating, confusion, impaired vision, clammy skin, delayed breathing, and muscle weakness is common signs of a possible Tapentadol overdose.
Skip the missed dose and carry on with your usual dosing routine. Do not take an extra dose to make up for the missed one.

What Are The Causes Of Back Pain?

Back pain is the most common medical problem worldwide, ranging from dull, constant aches to severe pain. Walking, sleeping, working, or doing other activities might be difficult. It can be diagnosed through CT, MRI, spine X-ray, or electromyography (EMG). 

The factors affecting the severity of back pain include age, weight, overall health, occupation, lifestyle, disease, or mental disorder. Back pain can occur from different injuries or conditions, often due to damage to tendons or muscles in the back.

  • Fractures
  • Stress and sprains
  • Structural problem
  • Disk problems
  • Arthritis
  • Spondylolisthesis

Diseases such as spine tumors, kidney stones, abdominal aortic aneurysms, sleep disorders, shingles

Usually, lower back pain gets better with pain relievers, rest, and physical therapy (PT). Also, Back pain that does not respond well to OTC painkillers may require a prescription NSAID. Cortisone injections and hands-on treatments (like osteopathic or chiropractic manipulation) can relieve pain and help to heal.

Can Tapentadol Treat Back Pain?

Tapentadol has a multimodal function system characterized by a unique mechanism of action that makes it the first representative of a class of solid central analgesics called mu-opioid agonist receptor and noradrenaline reuptake inhibitor (MOR-NRI). 

Worldwide, back pain (including lower back and neck) is the leading cause of disability. This pain is challenging to treat since it presents both a nociceptive and a neuropathic component.

Selection of treatment should therefore consider the ability to prevent this event. Tapentadol acts on both the nociceptive and neuropathic components of pain and thus helps to relieve back pain.

Tapentadol Dosages For Back Pain 

Usual Adult Dose for Acute Pain

Individualise therapy by considering the severity of pain, response to therapy, prior analgesic treatment experience, and risk factors for Abuse, misuse, and addiction:


  • Initial dose: 50 to 100 mg oral every 4 to 6 hours as required 
  • Continuation Dose: (if needed) Administer within an hour after the first dose. 
  • The maximum Dosage is 700 mg.
  1. Consume its lowest dose for the shortest duration or take the drug as the healthcare practitioner recommends.
  2. Monitor regularly for respiratory depression, especially within the first 24 - 72 hours after the start of therapy and with an increase in each dose.
  3. Due to addiction, Abuse, and misuse risks, even at recommended doses, reserve use for patients for whom alternative treatment options (e.g., non-opioid analgesics or opioid combination products) have not been tolerated or provided are not expected to provide adequate analgesia.

Dose For Chronic Pain

Individualise therapy by taking into consideration the severity of pain, response to drugs, medical history, and risk factors for addiction, Abuse, and Misuse:

  • Discontinue all other Tapentadol and Tramadol products before starting Tapentadol extended-release tablets

Studies Related To Tapentadol Use In Back Pain

Both comparative and experimental studies were used to study the efficacy and Safety of Tapentadol in back pain patients.

A study by Gálvez and colleagues evaluated the efficacy and tolerability of Tapentadol PR in chronic low back pain in patients with poor opioid tolerance. It was a Phase IIIb study using an open-label design and no control group.

Patients received 50-250 mg Tapentadol PR twice daily over a five-week titration and a seven-week maintenance period. The prevalence of adverse effects was less likely for Tapentadol PR. These findings indicate that Tapentadol PR was more tolerable and offered comparable analgesia to opioids in patients with severe, persistent low back pain.

Guellen-Astete conducted a retrospective observational study to assess patients who visited the emergency department for LBP over 24 months. 91 of the 732 patients received Tapentadol treatment.

Reassessments were less common in the first month following the initial evaluation in the Tapentadol group, achieving statistical significance starting on day 8. Compared to individuals who did not take Tapentadol, patients who took it had improved clinical pain evolution.

Side Effects Of Tapentadol

The side effects of all opioids, including Tapentadol, can include breathing problems that are lethal or life-threatening. Similar to other opioids, Tapentadol has several side effects, including-

  • Nausea
  • Dizziness
  • Drowsiness
  • Digestive issues like constipation or vomiting,
  • Headache
  • Heartburn.
  • Stomach pain.
  • Dry mouth.
  • Excessive tiredness.
  • Anxiety.
  • Difficulty falling asleep or staying asleep

Precautions Before Taking Tapentadol

The new FDA Opioid Analgesic REMS has been designed to communicate the severe risks of opioid pain medications to patients and healthcare professionals. It involves a medication guide and elements to ensure safe use. 

  • Drug Abuse, Misuse, and Addiction: Addiction to, Abuse, or misuse of this drug can lead to overdose and death. Assess each patient's risk before prescribing and regularly monitor for these behaviors or conditions.
  • Life-Threatening Respiratory Depression: Close monitoring is required after initiating or following a dose increase. The fatal outcome can occur with respiratory depression.
  • Accidental Ingestion: Accidental ingestion of the drug, especially in children, can be fatal.
  • Interaction with Alcohol: Do not consume alcoholic beverages or use products containing alcohol while on this drug, as it may result in fatal plasma Tapentadol levels.
  • Risks from Concomitant Use of Benzodiazepines or other CNS Depressants: Tapentadol with CNS depressants or benzodiazepines may result in extreme sedation, coma, respiratory depression, and death. 
  • Neonatal Opioid Withdrawal Syndrome: According to neonatal experts, prolonged use of any opioid during pregnancy can result in this life-threatening syndrome if not recognized and treated adequately.

Bottom Line From Practical Anxiety Solutions

Back pain is the most common medical problem worldwide, ranging from dull, constant aches to severe pain. It can occur from different injuries or conditions, often due to damage to tendons or muscles in the back.

Treatment options include adequate rest, physical therapy, and pain relievers. 
Tapentadol is unique among centrally-acting analgesics, combining MOR agonism and NRI in one molecule.

Therefore, it has been proposed as the first-in-class of the novel MOR-NRI class of analgesics. The molecule acts on nociceptive and neuropathic components,  making it a well-suited option for treating a mixed pain condition such as back pain. Due to the necessity of long-term treatment for back pain, this favorable Safety profile of the drug is especially significant. 

  • Buynak, R., Shapiro, D. Y., Okamoto, A., Hove, I. V., Rauschkolb, C., Steup, A., Lange, B., Lange, C., & Etropolski, M. (2010). Efficacy and safety of tapentadol extended release for the management of chronic low back pain: results of a prospective, randomized, double-blind, placebo- and active-controlled Phase III study. Expert Opinion on Pharmacotherapy, 11(11), 1787–1804. 
  • Langford, R. M., Knaggs, R., Farquhar-Smith, P., & Dickenson, A. H. (2016). Is tapentadol different from classical opioids? A review of the evidence. British Journal of Pain, 10(4), 217–221. 
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