I was given Tramadol too. They told me to take 2 pills up to 4x a day as needed. The problem was that at that point I was in such pain walking 4 feet made me need it so I was taking it 2x - 3x a day everyday. Then my pain got worse and I started taking more than I was prescribed (half to one whole pill over) because my Dr wouldn't return my calls for over 3 weeks and this was the only thing that offered any relief. (I did call my Dr. and tell him I was doing this in 2 messeges but he still never called back). However once the prescription ran out early I was in trouble and ended up going through withdrawal and in the ER. (Still no call from my Dr.)
Now I don't take it (and am with a different Dr., which is a whole other story) I am on Gabapentin, Lyrica, Amitryptiline, and Baclofen for my PN. (And Methotrexate for the Auto-Immune that might be causing it)
But everyone needs different things and different ammounts of drugs to be helped. So maybe for you a small amount of Ultram to help you over the bumps will be ok. I wish you the best.