"i am a helicopter pilot for the us army and i have chronic upper back pain.  i am on the 200mg ultram and it is a life savor.  it still allows me to fly and controls the pain.  my only issues with this drug is it tends to make me itch and i can&#039;t take it before bed or i will be awake all night.  i have been taking it as needed for the past 6 months."