"this is an exceptional drug for pain relief but the side effects far outweigh the pain relieving benefits. i took ultram er,300 mg for 3 months for low back pain and like i said it was a savior for my pain. however, i started to have some strange dreams with muscle spasms, constipation and extreme fatigue. i stopped the drug about 10 days ago and have finally started to feel better. i am 73 years old and in good health, except for the back pain."