pain
"Took severe pain away. Hand and neck arthritis. Take with 2 Tylenol or ibuprofen  every other dose for best relief. Brand name ultram 50 mg every 5-6 hrs if needed. For me, took most pain away! Better than vicodin and not sure why but so happy I have it. Cons: occasional nausea and big time constipation-take with laxative or colace. I started pill slowly- two 25mg per day over period of a week and worked up to 50 3 x per day over 3 weeks."