"i&#039;ve been on pain medicines since i was 8, for degenerative disc disease. starting when i was 24 and after surgery for herniated discs (l3-l4, l4-l5) i went through quite a few medicine trials before i found ultram. this one worked great until my l5-s1 herniated and the last epidural i received triggered severe sciatic pain. after a visit to the ed, i was given dilaudid 2mg intramuscularly and sent home with a script for the oral 2mg 1-2 tablets as needed. between ultram, gabapentin and dilaudid (alternating ultram during the day and dilaudid at night), i can still keep working for a little while longer until the next spinal surgery. ultram does not replace dilaudid, but i found it keeps me alert and pain level within my pain tolerance range."