SUMAYYA
20 August 2022
Medically reviewed by
Kajal Jain
M. Pharm
tapentadol-for-musculosskeleton-pain-copy
Table of Contents

Musculoskeletal pain is chronic or acute pain affecting muscles, bones, tendons, ligaments, and nerves. Billions of people suffer from this pain, with lower back pain being the single leading cause of disorder in 160 countries. It is typically characterized by pain and limitation in agility and mobility, reducing people's ability to work and participate in social activities.

Musculoskeletal condition is characterized by pain in various body parts such as Bones, Joints, Muscles, and Multiple body parts, including inflammatory diseases. Osteoarthritis (O.A.) is the most common joint disorder, affecting 32.5 million adults in the U.S.United States. 

Osteoarthritis affects 13.9% of people over 24 and 33.6% over 64. Osteoarthritis is a degenerative disorder of the joint in which joint tissue breaks down over time. People with O.A. usually have joint pain that stiffens for a short period after rest or inactivity.

The causes of musculoskeletal pain can vary. Muscle tissue can be destroyed with wear and tear during daily activities. Also, change in body posture or poor body mechanics may cause spinal alignment disorder and muscle shortening, causing other muscles to be overused and painful. 

Symptoms Of Musculoskeletal Pain

  • Bone pain may be sharp, dull, deep, or stabbing and is more unpleasant than muscle or tendon pain. 
  • Joint pain may be aching and may cause stiffness or swelling. 
  • Nerve compression pain may feel like pins, tingling, or burns. 
  • Fibromyalgia may cause multiple tender spots throughout the body. 

Rest symptoms vary with the individual, but common symptoms include sleep disturbances, muscle cramps, fatigue, aching and stiffness, pain with mobility, bruising, swelling, and soreness.

What Is Tapentadol Used For?

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

Tapentadol is an alternative for patients who do not respond quickly to commonly prescribed opioid analgesics. This medicine is unsafe for pregnant or breastfeeding women and should inform about the same to the healthcare practitioner. 

Tapentadol is highly effective in the following conditions-

  • Neuropathic pain is associated with diabetic peripheral neuropathy, which treats pain due to nerve damage in diabetic patients.
  • Moderate to severe pain, musculoskeletal pain, including neuropathic pain associated with diabetic peripheral neuropathy.
  • Chronic pain

Is Tapentadol Effective For Musculoskeletal Pain?

Musculoskeletal pain is a common medical problem worldwide that affects people of all ages but is particularly common in older patients. Specifically, lower back pain is more frequent chronic pain, with a prevalence of more than 70% in western countries and neck pain, another type of musculoskeletal pain, is also a common disabling disorder, with a majority of 23%. Both these disorders involve neuropathic and nociceptive pain mechanisms.

Tapentadol E.R. provided effective and well-tolerated treatment of severe chronic O.A. pain concerning the incidence of specific adverse events. The favorable tolerability profile supports Tapentadol E.R. as a treatment option before other opioids.

Two most commonly used chronic pain medications are Non-steroidal anti-inflammatory drugs (NSAIDs) and opioid analgesics. Tapentadol is a novel opioid pharmacotherapy with a dual mechanism of action and provides efficacy of the potent opioid and improved Safety with good tolerability compared to other analgesics.

Tapentadol exerts minimal serotoninergic action and has a reliable pharmacokinetic profile that makes drug-drug interaction unlikely.

Other Alternatives for Musculoskeletal Pain

The optimal choice of pharmacotherapy depends on the type of pain syndrome. For treating musculoskeletal pain with multiple joints, Non-steroidal anti-inflammatory drugs (NSAIDs) are also considered the drug of choice other than opioid analgesics. 

Topical NSAIDs may be used in case of localized arthritis or case of focal myofascial pain conditions. Where opioids are highly effective for acute nociceptive pain, their use in chronic pain is uncertain. Combination therapy, including antidepressant and anti-seizure medications, is often used, particularly for patients with neoplastic or centralized pain. 

The treatment choice should be based on individual pain conditions (if known), patient-specific characteristics, patient values, medication side effect profiles, and preferences. The preferences also influence the narrower choice of drug within a class about side effects, dosing frequency, and patient's age. Cyclobenzaprine is another alternative initial drug for patients with mild to moderate Fibromyalgia symptoms. 

Tizanidine and cyclobenzaprine are best suited for individuals with acute low back pain but with minimal evidence of efficacy for chronic back pain.

Tramadol is a mixed-mechanism opioid with a weak affinity for the mu-opioid receptor and serotonin and norepinephrine reuptake inhibition. Like other opioids, it may be used as a second-line agent for patients with Fibromyalgia who have not responded to initial therapy with other agents.

Dosages of Tapentaol Pain

  • Initial dose: 50 mg twice daily.
  • Continuation Dose: As early as one hour after the first dose 

Acute Moderate- to-Severe Pain

Immediate-release tablet or oral solution: 

  • 50-100 mg P.O. every 4-6 hrs; 
  • Do not exceed 700 mg on the first day 1 and 600 mg/day following days.

Chronic (extended-release tablet)

  • 50-250 mg as needed every 12 hours

Opioid-naive patients: 

  • Start with 50 mg B.D. Every 12hr as required; not to exceed 500 mg/day.

Opioid-experienced patients: 

  • The initial dose depends on the type of previous analgesic used.

Chronic Severe Pain

  • 50-250 mg as needed every 12 hours
  • Not to exceed 500 mg/day.

Opioid-naive patients: 

  • 50 mg P.O. every 12 hours; titrated to optimal dosage as required; 
  • Not to exceed 500 mg/day.

Side Effects Of Tapendatol

Side effects are a part of medication that can be affected by the people who consume it. The effects are differentiated into two variations such as standard and severe. As common effects can be cured as time passes, severe effects should be considered, and medical emergencies should be taken as soon as possible. 

Common Side Effects Severe Side Effects
Constipation Shallow breathing
nausea Light-headedness
Vomiting Severe drowsiness
Headache Seizures
Dizziness Hallucination

Precautions of Tapentadol Medicine

It is always helpful to take precautions if you are about to take any medicine. This will help you deal with unwanted side effects, and the working of the medication will be smooth without interruption.

It would be best to inform your doctor about your medical history and all the medicines you consumed to treat the condition. You should not take medication if you:

  • Have any severe breathing problems
  • Facing any bowel obstruction
  • Have any asthma
  • Have you ever suffered from a head injury
  • Have been through liver or kidney issues
  • Have you been through any urination problems

Drug Interactions with Tapentadol

Chances of you consuming other medicine would interact with Tapentadol. So it is always necessary for you to get a prior understanding of medicines that would interact with Tapentadol. 

Medicines that would Interact with Tapentadol are as follows:

  • Medicines used for treating Allergies
  • Blood pressure medicines
  • Opioid medicines
  • Benzodiazepines
  • Muscle relaxers
  • Antidepressants

Bottom Line From Practical Anxiety Solutions

Musculoskeletal pain is characterized as the most common medical problem worldwide. It might lead to a temporary or lifelong disability in function or participation as it affects various body parts such as muscles, bones, joints, and other details. Its symptoms may vary with the individual, but common symptoms include stiffness, swelling, tingling, or burning sensation.

Tapentadol is a highly effective opioid pharmacotherapy as it is safe, reliable, and well-tolerated with no possibility of drug-drug interactions. Apart from Tapentadol, there are other pharmacotherapy measures and natural remedies for treating musculoskeletal pain.

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  • Ferri, Cesar Margarit, et al. "Quality of life and functional outcomes with Tapentadol prolonged release in chronic musculoskeletal pain: post hoc analysis." Pain Management 11.2 (2021): 173-187. https://doi.org/10.2217/pmt-2020-0084 Obtain On 11/11/2022
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  • Ruggeri, M., Signorini, A., Caravaggio, S. et al. Cost-Effectiveness Analysis of Tapentadol Versus Oxycodone/Naloxone in both Branded and Generic Formulations in Patients with Musculoskeletal Pain. Clin Drug Investig 41, 875–883 (2021). https://doi.org/10.1007/s40261-021-01074-x Obtain On 11/11/2022
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