It works for some people.
Back before my surgery, I had seen approximately 20 different doctors, all who had varying opinions on what was wrong with me, and each gave me different medications.
One of those medications was generic ultram. While it didn't work on the multitude of pain problems I had, nerve damage, severed nerves, synovial cysts, herniated and collapsed discs, it does work for a friend of mine who has milder pain.
She says it's the only medication she has taken in years that helps her with her sciatica.
I don't like all the meds I have to take, but they are working.
