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If Ultram helps you, I know of another medication that might work as well. It is difficult to get, because it is an older drug, not widely prescribed,therefore not profitable for the drug companies and the rights have been sold and re-sold several times over the past few years, so it is sort of out there in nomansland at the moment. But it's called Levo-Dromoran, and the generic form, Levorphanol, is sometimes available. My own pain neurologist has made an arrangement with a local pharmacy to obtain the generic and compound it themselves for his patients. He has told me that it doesn't work for everyone, but for those patients it does help, it is a lifesaver. I am one of them -- without it,I would be bedridden. I also take Ultram. Good luck.