Maybe it's time to change docs. There are countless docs out there that claim RSD/CRPS experience that are pretty darn clueless.

If tramadol doesn't work there are several other meds that are in the same family that you might do better with. You also need to try some of these meds for a month before you'll notice a difference and even then the dosage might need to be increased slowly to find the optimal results.

I would ask about low dose naltrexone since it supposedly has the pain reduction benefits of an opiate with none of the side effects.

I spent a few years guarding my arm and it took a lot of work in physical therapy and with a pain psychologist to unlearn that bad habit. I had major atrophy in my hand/wrist at the time and I caused permanent damage to my elbow, shoulder, neck and back that are still with me 12 years later.

The RIGHT physical therapist might be of some help to avoid surgery. Warm water pt might also be a good choice.