Yes, over time, it has improved.

Mine appears to be arthritis plus some muscle spasms.

I use a lotion on my neck there, called Morton Epsom lotion, and
this relaxes the spasming muscles. For really bad times which are not everyday, I have Flexeril.

I had shingles in my upper neck and down my right arm, and I find taking a gram or 2 of lysine also helpful, so I guess there is a viral trigger in there as well. (Herpes Zoster).

I don't have everyday pain, and I consider myself lucky.

Tramadol has to be activated to its active metabolite to work. This can take up to 2 hrs from when you take it.
Also some people don't have the enzyme that does this, so for them Tramadol apparently doesn't work at all.

So the delay in onset gives the impression of not working, and then you take Tylenol on top of it, and that works, so when the Tramadol kicks in, it is concealed by the Tylenol.