"i underwent a two-level lumbo-sacral spine fusion (2-level plif) in 2007 and have been on tramadol for chronic pain since then.  i find that tramadol works as well as most opioids with less impairment at similar levels of pain relief.  i have experienced two seizures thought to be caused by tramadol while i was titrating upward on the drug, but have had no problems since.  i have tried titrating off of tramadol twice and in both instances experienced moderate withdrawal symptoms of the opiate type almost immediately.  overall i consider it a very effective analgesic for chronic low back pain with few side effects, but would recommend a prolonged titration off of the drug if you decide to discontinue use.  i give it a thumbs-up."