Start reading. Tramadol is a complex drug, or at least works on a bunch of stuff at the same time.
http://en.wikipedia.org/wiki/Tramadol
And now that I just read that, I find it odd that I went through a 5 year period of increasing tramadol usage, holy shit I had these REALLY big bottles of it, and in the end kind of freaked and HAD to stop. And then a few years later I went to a shrink to get effexor (actually, cymbalta, but my insurance said no) for pain. My regular Dr would not prescribe an SNRI to me, he said the shrink was needed. So I went to a shrink NOT to change, but for a specific drug to kill pain that was NOT a narcotic. Shrink did NOT like this, he wasn't there to peddle drugs, and said I needed a few sessions. Sure, I can talk.
I BROKE that shrink. I had him SCREAMING at me:
WHAT THE FUCK DO THESE WOMEN SEE IN YOU!?!?!?!
That was FUN.
So anyway, he prescribed the effexor, it DID help with my pain, it also got me off my ass and out of the house, divorced the wife, started a new life.
I THEN started smoking pot again (after a 27 year break) and had no reason for the effexor, the pot handled the pain.
You need better pot.