chronic pain
"I have severe pain from spinal stenosis through my neck, right shoulder, arm and hand.  Dr. prescribed Tramadol for this pain.  I  used the drug as directed with little relief from the intense pain.  The prescription called for 1 to 2 pills every 4 to 6 hours.  I took two pills every 4 hours, for 10 days, that's a total of 60 pills with very little effect.  I do not recommend this drug.  Lack of effectiveness can cause you to take more of the medication than you should and increases the addiction risk."