TRAMADOL Is a Pain Reliever that Brings Relief or Regret!

We rarely observe a medication that has such staunch supporters — or bitter critics — as tramadol. This is truly a love-hate pharmaceutical relationship! As you will shortly read, tramadol is a pain reliever that inspires fierce loyalty from many people. They describe long-awaited relief. Others get little benefit and feel trapped by tramadol because stopping the drug suddenly produces unbearable withdrawal. There does not seem to be a way to predict in advance who will benefit and who will suffer.

Tramadol: A Pain Reliever That Has a Checkered Past:

Tramadol (Ultram, Ultracet) has been on the market in the US for 30 years. It was initially marketed as a safer option than traditional opioid analgesics.

Doctors were told that it provided very good pain relief without the risk of physical dependence associated with traditional pain relievers. That suggested the drug had a “low potential for abuse.”

In those early days the FDA considered tramadol a “non-controlled” analgesic. That meant the experts believed the medication would not cause physical dependence or a “withdrawal syndrome.”

That confidence didn’t last. In 2014, the Drug Enforcement Administration (DEA) reclassified tramadol as a Schedule IV controlled substance, acknowledging its potential for abuse and dependence. It’s still often viewed as safer than drugs like hydrocodone or oxycodone (Schedule II), but many people have learned the hard way that tramadol can come with its own unique set of challenges.

Tramadol Is a Pain Reliever That Creates Strong Emotions:

Patients Who Appreciate Tramadol Relief:

Nancy appreciates tramadol:

“Tramadol was a life saver when I fractured my back and during a gallbladder attack. Aside from constipation, no problem.”

D.L. says that tramadol worked very well for pain:

“I have taken tramadol for almost 20 years now. What a life saver! It has helped me with arthritis pain and now lower back pain. No one has to suffer with constipation with an opioid drug, just take something for it like Miralax, or just eat more salad and fruit and grains.”

Lowell says tramadol has been a blessing:

“Tramadol has been a huge blessing for me these last 15+ years. I had constant pain in my left hamstring, and the only solution that has worked has been Tramadol. I tried at least a dozen other solutions and tests before settling on Tramadol. I do come off of it every five years or so, to see if the pain comes back, and it does.

“Withdrawal symptoms are bad. It takes 6+ weeks of cutting back before I can stop. During that time, sleep is terrible. Over the years I have had to jump thru more and more hoops to get prescriptions filled. It’s a shame that the people who need it have to work so hard to get it, and those who abuse opioids are still able to easily get them.”

Eileen is grateful for the pain relief:

“Tramadol worked very well for my chronic pain. I took it once a day and then twice/day for a couple years. I have serious spinal degeneration. The pain can get excruciating but the tramadol helped a lot. It also didn’t cause constipation.”

Ann uses tramadol off-label for severe head pain:

“I take a 50mg tramadol when I have a migraine. I go through roughly 20 pills a year. This has worked for 23 years with no addiction or side effects. It is a shame that many doctors are reluctant to prescribe tramadol and push for experimenting with new meds. I see no reason to stop doing something that works.”

Kelly needs tramadol to walk:

“I’ve taken tramadol for years (4 ruptured disks in my lower back). Without it I can hardly walk (I look like an upside down L). With it I can exercise (lift lighter weights, play tennis daily, etc.). I take 2 tabs a day. NO side effects. Please do not scare folks into believing this is similar to seriously addicting opioids.”

Patty has had no problems with tramadol:

“I’ve been on tramadol for 18 years without any side affects. Tramadol isn’t a strong pain medication, and it’s only classified as an opioid because the DEA changed its classification due to the opioid problem.”

Tramadol Is a Pain Reliever That Left These People Disappointed:

A reader’s ordeal:

“After a freak accident that left me with a spiral fracture of my humerus and a broken shoulder, I was first prescribed opioids and then switched to tramadol because it was supposed to be non-addictive. It worked better than the others, so I stayed on it for a while. When I tried to stop, I came down with what felt like the flu—shaking, sweating, muscle pain, runny nose. As soon as I took another tramadol, it all disappeared. That’s when I realized I was dependent.

“My pharmacist told me it wasn’t addictive, and my doctor dismissed it as psychological. But it was very real.I finally quit cold turkey, and it was harder than anything I’d ever experienced. Later, I read online that some people think tramadol is even harder to quit than heroin. Everyone should be warned.”

A pharmacist’s perspective

“In the early 2000s, I would call doctors about patients showing clear signs of withdrawal. Most didn’t believe it was possible. Once in a while, I convinced a physician to prescribe a small taper so patients could come off safely.

“Too many doctors still think tramadol is easy to stop—but it’s not. Like steroids, it can’t be discontinued abruptly without serious consequences. Good pharmacists try to advocate for patients, but it takes time—and time is what’s missing from so many modern pharmacy interactions, especially mail-order ones.”

Larry describes a delayed side effects:

“Tramadol (Ultram) is known, after a time of weeks to months, to produce tremor. With continued use, this progresses to brain fog.

“The patient or spouse has to figure this out. Eight doctors including a neurologist and a pharmacist couldn’t do it. The black box warning didn’t do it.”

Candace developed low blood sugar while taking tramadol:

“I have been on tramadol for many years and I have had issues with low blood sugar. I have never been diagnosed with diabetes (I have been tested) but I know how my body feels when my blood sugar drops. I never had any idea this could be a side effect from the tramadol.”

Rita says that tramadol was a nightmare for her dad:

“Tramadol for my dad’s bladder cancer treatment pain was a nightmare – literally. He was 91 and very mentally sharp. It caused him to have several psychotic episodes before I could get the hospital doctors to stop prescribing it to him. My research indicated this is more common in the elderly.”

Deborah experienced withdrawal when she stopped tramadol:

“I have been taking tramadol for back pain for several years. I was never told about the possible withdrawal symptoms and found out only after discontinuing the tramadol suddenly due to an unrelated surgery when they advised me to stop it. I went into withdrawal at home and experienced the twitching, cold, nose running, zaps and nausea without knowing what was causing it. It was very scary until I figured out it was the discontinuance of the tramadol.

“I resumed tramadol at 50 mg 3 times per day. About 9 months ago I was determined to get off of it. I started taking only 3/4 of the nighttime dose, then tapered to half. I stayed with that dosage for two months and gradually reduced a half for each two month period. I am down to 2 half-pills per day. I will continue this for 2 months and eventually wean myself off this way. I found that the tramadol wasn’t even working anyway.”

Trina says the withdrawal was awful:

“I’ve been taking tramadol off and on for the past 2 years; sometimes more sometimes none. On Sept. 21 I quit cold turkey, It’s now the 7 of Oct., and the first week was horrible. I had a rage of anger; I had crying, anxiety, depression, weird thoughts, was irritable and not sleeping, which drove me crazy. I didn’t want to see or talk to anyone except my husband.

“Today makes 2 weeks. I feel a little better but still not myself. I can’t focus on TV so have just been reading about tramadol hoping someone can help me. Trust me, it’s been hard but I am never touching this drug again.

“The worst feeling is no sleep. I’m 60 years old, spent some time in the military, and am strong-willed but I think the worst part is lack of sleep. I don’t know when it’s gonna get better.”

Tramadol Is a Pain Reliever That Can Trigger Side Effects and Withdrawal Symptoms:

Unlike most opioids, tramadol doesn’t just act on the body’s opioid receptors. It also affects serotonin and norepinephrine, the same brain chemicals modified by certain antidepressants. That means quitting tramadol can trigger both opioid withdrawal and antidepressant-like discontinuation symptoms—a double whammy that can make the process brutal.

Tramadol Side Effects May Include:

• Dizziness, coordination difficulties
• Nausea, vomiting or diarrhea
• Abdominal pain, indigestion, diarrhea
• Constipation
• Sleepiness, drowsiness, fatigue
• Sweating
• Low blood sugar (hypoglycemia)
• Anxiety, confusion, cognitive dysfunction, restlessness
• Headache
• Insomnia
• Seizures
• Breathing difficulties (shortness of breath)
• Suicidal thoughts
• Low blood pressure on standing, hypertension, irregular heart rhythms
• Serotonin syndrome

Tramadol Withdrawal Syndrome:

• Anxiety, mood swings, irritability
• Brain zaps (shock-like sensations), tingling
• Sweating, chills, goose bumps, shivering
• Tremors
• Headaches
• Insomnia, sleeping difficulties, nightmares
• Flu-like symptoms
• Nausea, vomiting, diarrhea, loss of appetite
• Depression
• Hallucinations, unusual thoughts
• Aggressiveness

Some of these symptoms of a discontinuation syndrome can last for weeks or even months, depending on the dose, a person’s brain chemistry and how long the person has been taking tramadol.

Proceed with Caution—and Compassion

We wish more prescribers warned patients about the pros and cons of tramadol in advance. Tapering slowly, sometimes over weeks, is far safer than stopping suddenly. And patients who’ve been told “it’s not addictive” deserve understanding—not dismissal—if they struggle to quit.

For many, tramadol truly is a lifeline for managing pain. But for others, it becomes a trap they never expected. The truth is that both experiences are real—and they can exist in the same pill bottle.

Tramadol Is a Pain Reliever That Affects People Differently — What Has Been your Experience?

We’ve heard from readers who say it changed their lives for the better, and from others who say it was the hardest drug they’ve ever stopped. You can share your experience in the comment section below. Please share this article with those who might be talking tramadol, so if they stop (under medical supervision) they will not experience a withdrawal syndrome.

If you would like to learn more about tramadol and gabapentin, we recently wrote this overview:

Gabapentin and Tramadol Under Scrutiny

A study published in BMJ Evidence-Based Medicine (Oct. 7, 2025) reported that tramadol “…may have a slight effect on reducing chronic pain levels…” The authors go on to state: “The potential harms associated with tramadol use for pain management likely outweigh its limited benefits.”

If you have learned nothing else from this article, it is that patients are different. Some get meaningful relief from pain while others get little benefit and suffer both side effects and withdrawal symptoms when they stop tramadol.