I know ultracet/ultram/tramadol is used for a lot of different types of pain, but I've been hearing that it tends to be the only thing (or one of few) that relieves FM pain. Is this true for most of you? When I saw rheumy last week, I was really hurting and my blood pressure was way too high. Since I am scheduled to have a hyterectomy this week - and he wants it as much as anyone, to see if that takes care of the whole pain issue - he told me to take tramadol 3x a day to lower pain and hopefully BP. I had never taken it more than 2x a day and only when I was really uncomfortable. It has helped. In fact, I got so busy today I only took it late morning and a short time ago, I started getting that sickly aching. I don't want to be in a flare going into surgery, since I have heard it can be worse afterward! However, I have been hurting more constantly than ever - maybe, as I said in another post - because I tapered prednisone to 2mg, which is the lowest I have been in over a year. Maybe the lowest since this all over aching has come on, making it even more difficult for a solid diagnosis, even by a rheumy who specializes in it. Anyway, I'm just wondering if ultram/tramadol does seem to be the most effective for FM pain. If so, does it take more than the usual prescribed 2x/day? (Now I understand 4x/day is even OK.) Do you know why?