I hear you, I feel it just a couple hours late. Seems like if I'm late it takes a day or so to get back up to the same pain relief level.

I've been on the maximum dosage of Tramadol plus Lyrica for two years now, couldn't tolerate without it. I've cut down several times with no adverse effects except increased pain.
There are some real horror stories about Tramadol withdrawal though but you have to remember that the people who have no problems usually don't say anything.

One thing that surprised me recently was the Tramadol prescription my friend's dog received.
It was the same as mine, two 50mg tabs up to four times a day!
This was for a 50 lb dog!
Tabs looked exactly the same as mine, wonder if they're cheaper from the vet?