"over five years ago i was told no more nsaidss because of kidney disease.  i had found naproxen sodium effective for arthritis pain and migraine headaches.  now because if the kidney disease i was prescribed tramadol, up to 100 mg four times a day.  at first i thought it was a joke. it was not nearly as effective as over-the-counter naproxen.  but i stuck with it because i had to. gradually i became aware of its pain reducing qualities.  recently i had joint replacement therapy and had good pain relief but terrible side effects from oxycodone  i went back to tramadol and it was enough to take the edge off.  i have noticed the headache that many mention in their reviews, but it&#039;s mild and short lived. i even take tramadol for real headaches!"