"i&#039;d like say there are many misinformed people here. tramadol does help all kinds of pain. tramadol is an opioid, it attaches to the same receptors oxycodone does, and it&#039;s a prodrug -- meaning it must metabolize via cyp2d6 liver enzyme to work. 
once it&#039;s converted over, it turns into m1 aka o-deso (for short) which is 6-10 times more potent than tramadol, where it&#039;s real pain relief comes from. so people giving it 1 star? 
they are lacking proper metabolism or they are taking a p2d6 inhibitor (some antiacids, like tagament), grapefruit juice, among others. 
a 50mg tramadol tablet in studies has superior pain relief to 40mg codeine+300mg tyneol, and also showed the same pain relief as 5 to 7.5mg of oxycodone. it works for pain..."