Pros: Better tolerated than other narcotics, very low addiction risk
Cons: Stigma as a "weak" painkiller (not true)
GET YOUR INFO FROM THE RIGHT PLACES:
I am not going to just cut and paste info from drug info web sites, I suggest you look this up in the Physicians Desk Reference (PDR) or via a site like drugs.com to be sure you understand all of the possible side effects, adverse reactions, interactions with other drugs/substances, dosages, etc.
Some of the info in other opinons I have seen about Tramadol from people posting on the web contain some misleading or wrong info. I really advise you, DO NOT base your use of this or any other drug based on something you read in epinions or on some blog! That can be very risky.
I have chronic back pain in my tailbone and can speak about my experience with that and how this drug works for me. It will satisfy the curiousity of those who want to learn about this drug from a regular person who has used it. I'll also share what I have learned about it. However, each person can have different responses to drugs and their specific situation, etc - so make sure you make your serious medication decisions based on advice from medical professionals.
BASIC INFO AND PERSPECTIVE:
Okay, all that said, here is my experience and it may help to at least give you some perspectives.
Tramadol (also know by the brand name "Ultram") is a centrally acting painkiller. It is a synthetic opiod drug that can be taken orally or intravenously. It is also seen under other names. When combined with Tylenol for example it can be called "Ultracet", typically a pill mixing tylenol with a weaker dose of Tramadol.
Straight Tramadol comes in 50MG or 100MG pills typically, and is also available in a 12-hour, extended release form.
It is NOT a scheduled drug (meaning that the DEA does not track who prescribes it and how much, like they do with Vicodin, Codeine, Percocet, etc). This means that doctors, who fear being audited and accused of pushing narcotics and perhaps punished, are much more comfortable prescribing Tramadol.
Tramadol has an action similar in some ways to other narcotic painkillers, but its not the same thing. I won't go into scientific jargon, but it changes chemical transmitters and receptors related to your body's pain sensing mechanizm but in ways just a bit different than your usual narcotic pain meds.
IS TRAMADOL REALLY ANY GOOD FOR SERIOUS PAIN?
You will find many studies of this drug if you google it and surf the web. Its been around since the 1970's. Well studied and proven to be effective without a question. This is a real, powerful pain med. It is used quite a bit in Europe. It is proven effective and used as a post-operative painkiller for example in some places; so that should give you an idea that it is a serious painkiller.
Many people who have moderate to severe pain expect to get Vicodin or Percocet or other narcotic painkillers, and are often disappointed to be prescribed Tramadol. Tramadol has been studied and compared to these drugs, and its proven that for many people with moderate to moderately severe pain, it can provide the same kind of powerful pain relief with far fewer side effects and with more safety. Tramadol is very well tolerated by most people when administered properly.
Tramadol compared to Morphine, for example, can have the same pain relief effect (if dosages are adjusted to match). For example 100MG of Tramadol (a common dose for severe pain) = 10 MG of morphine from a painkilling perspective.
Since Tramadol does not consistently produce the euphoric mental effect of the other narcotic drugs, many patients feel like its "weaker" and that its not effective. In fact, it is very effective for many people if given in the right dosage, and people who use it and say "its not helping" may not be taking the right dosage. I was one of those people. I got very little relief from 50MG of Tramadol, but at 100MG I got very good relief.
I do think that a heavy intravenous dose of morphine is frankly more of a sure bet for relief of massive pain, but you can't continue that for very long, and it has many more dangerous side effects.
More powerful narcotic drugs have more capability to control serious pain. However Tramadol is safer, easier on your body, and worth a try as it might be good enough to help you with your pain - with less drawbacks.
IS IT HIGHLY ADDICTIVE?
Tramadol does not produce the same kind of euphoria or pleasant "buzz" that many people think is good about Percocet, for example. For this reason, it is far less likely to cause addiction (there are some chemical reasons why its less addictive as well, but the subjective user experience is also a factor).
You may see some people making scary statements about Tramadol, saying its "high risk for addiction" and comparing it to morphine, etc. That is just not true for the average person. People who may get addicted to Tramadol, are in most cases people who are already having mental and physical problems with addictions. For example if you have been hooked on Vicodin in the past, and are still dealing with addictive personality traits, you are more likely to have a problem with other medications that could include Tramadol.
There have been studies of how people use narcotic/pain relief drugs, and those taking it for real pain do not get addicted. It's when people start taking it for reasons other than pain, when they take it when the are not feeling any more pain, that is where the problem occurs.
I can tell you that when I have had surgery and have been put on strong narcotic pain meds, I did not feel like it was a "fun" experience. I don't remember feeling high. I just remember being relieved that I could exist without being in agony. Its completely different when you take those drugs when you are not in pain. It then becomes more about a mood altering and emotional experience.
For the regular person who is not an addict, and who uses Tramadol as prescribed for REAL pain, addiction is an extremely low probability. Way lower than narcotic painkillers like oxycontin that you hear about in the news all the time.
The point I am trying to make is, don't run in fear from this drug thinking you will be hooked on it right away.
WHAT IS IT LIKE WHEN YOU TAKE IT?
Tramadol does give some people a slightly dizzy, a little bit "loopy" feeling at higher doses. You can definitely feel it. For me, its not an unpleasant feeling; and actually I feel a bit of a lift in my mood once it kicks in, in addition to the pain relief. But again its not what I think anyone would consider a recreational "high". Its not that kind of feeling. (take note - this is one reason why its not viewed by the FDA and DEA as a major addiction risk). You probably get more of an effect of your mental state from an over-the-counter antihistmine. How many people do you see in recovery for an addiction to cold medicine? You see my point.
The drug absorbs quickly (with or without food it absorbs equally as well), and you feel relief within about 1 hour after taking it; max effect at about 2 hours; and it lasts 4-6 hours for me before I might need another dose. You can take up to 400MG per day safely. If you are going to need to take it for an extended period, your doctor should work with you to build you up to higher doses slowly, as this will prevent a shock of side effects. If you are on high doses for several weeks, the doc will also want to reduce you down from it slowly once its time to stop it, to allow your body to adjust.
There can be side effects from Tramadol, many go away as your body gets used to the drug. Dizzyness, nausea, constipation are possibilities. You should not mix it with sedatives, other narcotics, alcohol - go to drugs.com or other official sources for the full list.
If you feel any odd effects when taking Tramadol, contact your doctor and get some guidance.
IS IT SAFER THAN OTHER NARCOTIC PAINKILLERS?
Tramadol was also studied and it was seen that it does not produce the same side effect of respiratory and cardio "depression" (slowing heartbeat and breathing) like the strong narcotics do. This makes it safer to use.
It has far less of a sedative effect as well.
And, there are some studies that say this drug has a similar chemical effect to anti-depressant drugs and can have some anti-depressant effect.
As I said before, its also safer from an addiction standpoint than your usual narcotic painkillers.
If you have some severe pain, and the doctor suggests Tramadol, give it a try. I was skeptical myself, but was pleasantly surprised at how well it works. Its safer, better tolerated, and far less addictive than other narcotic options.
If you are in some bad pain, and the doctor does not want to give you the typical narcotic painkillers (many don't, they are afraid of the DEA), and they are telling you take advil or tylenol or prescription strength anti-inflammatories like Naprocin, it cannot hurt to ask them about Tramadol. It will help you more and the odds are better they might prescribe it.