Dear Dr. Roach: I am a 72-year-old woman who, over my adult years, has developed allergies to Tylenol and all NSAIDs. Just this week, I developed a rash after taking aspirin, which was my last resort for pain. I was given a prescription for tramadol, but I really don’t want to take a narcotic for aches and pains I only have periodically. I use ice, heat, stretching and exercise, which keep me pain-free most of the time. — T.W.
Answer: I have rarely seen a person allergic to so many classes of medicines, but it can occasionally happen. It’s unfortunate, but I certainly agree with you that an opioid (the term narcotic isn’t used any more) is too powerful a medication to use lightly. There are serious side effects that can happen with tramadol, like any other opioid, and even appropriate use of opioids can lead to opioid use disorder. Misuse of prescription drugs is a huge problem in North America, and not prescribing them in the first place is a good way to prevent problems. (People who misuse opioids commonly get them from a friend or relative.)
Nonprescription ways of treating pain seem like a very good way to treat the occasional pains we all get. Topical treatments, like menthol, camphor-based creams or even topical NSAIDs like diclofenac, may not cause allergic responses, so you might have success trying those.
