I am one of those people who got discouraged with ultram in the begining as I was still working at the time and alot of Docs were prescribing it for elderly patients very leniently and I was caught off guard to the number of side effects associated with this med when they were hyping there was not any. In the elderly especially it was causing some very strange psychotic tendancies and in that age category these were not good things. So I am prejudiced against the drug early on.
I have not found very many people who get much if any relief from it and I know of not one who take it solely for CP without having to have anything else.
It warns you that it can and does cause w/d in narcotic tolerant folks so keep that in mind. Way too many Docs try to persuade us to take this instead of narcotics using very convincing statements to bring us around to thinking it is a strong pain med and I have heard them use this term widely in conjunction with tramadol.
Like Gramps said I think it is no stronger then OTC motrin and alot will find aleve is much better.
I can think of 10 better meds for migraine then this one.
As for the rheumy encouraging you to use it I dont get that either since unlike Ibuprophen and other Nsaids it has no antinflamatory properties to it.
I would certainly try it as long as it they dont want to replace my vicodin with it but would be really hesitant to just flat out make the switch! Alot of times it is nothing more then Docs using the same old song and dance and wanting to get another patient off narcotics and by switching from Vics to ultram they use the no aceteminophin in it to persuade us. There are however other narcotics with less or no tylenol if you require narcotic treatment for your pain to switch to if that is a concern as it usually is hence the GI statement not prescribing.
Good luck and if you are required to give up the Vics I would make sure they arrange a taper that is comfortable before doing so.