Have you tried ultracet? that is tramadol combined with acetimenophin (sp). I was actually started on ultracet because my rheumy believed it to be stronger than tramadol alone. I was taken off the ultracet and put on just tramadol when I started the mtx (because the acetimenophin taxes your liver as does mtx). Like tramadol, it is non-narcotic.
Current dx: Rheumatoid Arthritis
Suspected dx: UCTD/Early Lupus
Current Meds: Enbrel, Plaquenil, Methotrexate, nexium, tramadol, nasonex,Tylenol PM
Past Meds: Relafen, Vioxx, Mobic, Voltaren, Sulfasalazine, Entocort, Prednisone, Humira, Reglan, zyrtec, zegerid, aciphex