Tramadol and more general pain management

There are two types of pain:

acute, which is usually caused by a short-term injury, and
chronic which is pain likely to last over a long period of time.
By its nature, the causes of acute pain will usually respond well to surgery, physiotherapy and, where appropriate, rest. In these cases, using quite high doses of tramadol to produce immediate, but short-term, pain relief is the standard approach. But once it is obvious that the cause of the pain is a long-term condition, there are difficult decisions to be made.
There is clear evidence that taking tramadol over long periods of time at relatively high dosages leads to physical dependence. You will suffer withdrawal symptoms if you suddenly try to stop. Even if you taper the doses, the withdrawal may still be unpleasant. Thus, it is better to manage the pain in a way that allows you to avoid having to take high doses.
When you know that an acute injury is going to heal, it is easy to stay optimistic. When you know the pain is going to continue, it is easy to become depressed and allow yourself to think, and then act, like an invalid. People become afraid to move, fearing that movement will cause more pain. The fear leads them to stay still, perhaps even take to their beds on a permanent basis. Although understandable, this is the worst thing you can do.
Best practice today is to encourage everyone to remain mobile. This keeps up the muscle tone and prevents the joints from seizing up. The need is for you to learn coping strategies. Life must still go on even though you are in pain. You need practical lessons on how to do the routine things without causing excessive pain. Pain management is all about learning to live with new physical limits. More importantly, it aims to keep you positive. Fear and depression will just make the pain seem worse. You have to come to terms with the reality of your body. Yes, some movements will hurt a lot, but others will hurt less. You have to experiment to find the best ways of moving with the least pain.
In the early learning stages, it is alright to use tramadol at lower doses. It will help you to keep the pain to a minimum. But you should be exercising in a swimming pool — the buoyancy of the water allows you to move with less stress on the joints. A physiotherapist or other trained behavioral therapist can teach you how to achieve a better quality of life. To get the best results, you have to accept the pain and learn to live with it. Drugs like tramadol can only get you so far. The rest has to come from your hard work and determination not to be beaten.