I have severe arthritis in my shoulder. The tramadol is worse than taking nothing since it can upset my stomach. I have to wait 3 weeks for an appt. with a new Dr. since this dr. looked at me like "oh, well... " when I told him the Tramadol doesn't work. I need pain relief but I'm wary of this drug. Two pills in less than four hours and ... nothing! BTW this Dr. prescribed 50mg - 3 times a day... every 8 hours!! Geez