Right now in addition to going 2 hrs 1 way to the pain management clinic to get trigar point ijections in my abd. of Bubivicain, they started me on Ultram 50 mg every 4 hrs. It isn't constipating, snd doesn't make you sleepy, or "loopy" in the head. It doesn't work as well as the Narcotics but so far it has eased the pain enough that I can do short little tasks. I need to get back to work!!! (1 more month or i'll be fired) Any ideas on this? Lynette