Hi,I'm new here.and I have problems so please someone help me.I have been using Tramadol Inj.(i can't eat tablet)for almost 1 years cause of my spinal chord injury(SCI).. before last month I take 50mg twice daily,at last month it doesn't relieve the pain..so we up the dosage to 100mg and it work well.But then from last month when I take it again it work only a few hours..like 3 hours per 100mg..so we used again..from now on we have to use like three times a day sometimes four times...My question is that does it mean that my system is becoming immune to Tramadol..we are at a remote place..we can't find any other medicine that relieve the pain i.e the chronic spinal cord pain..so what im i gonna do?the doctors tell me not to exceed 400mg per day..I'm need help desperately??

Yes, tramadol is habituating and tolerance may develop over time which then would require a higher dose.

Tramadol has to be activated by the liver to its active metabolite and hence there is a delay in action and perception of relief.

http://en.wikipedia.org/wiki/Tramadol

In doses over 400mg or even approaching 400, people may start to have seizures. This drug also affects serotonin levels, and may interact with serotonergic drugs like SSRIs for depression.

A subset of patients do become addicted...meaning seeking more of the drug for subjective "high" effects. At the high doses there can be withdrawal symptoms if stopped quickly. Tapering off is the best method to discontinue.

thanks..but what im i gonna do

I don't know, Leo. Even patients with better access have to learn to manage their medications and find other ways of managing pain.

You weren't by chance trying to eliminate the pain, were you? Because that's not the purpose of pain medication. The purpose is to relieve the sense of suffering and improve the quality of life. We all have to expect to deal with certain reasonable levels of pain.

Have you been through physical therapy?

Many of us help control pain with distraction. Some get relief by using a TENS unit, which can be gotten online/mail order (you may need a prescription).

Some can learn biofeedback, self-hypnosis, and/or mindfulness meditation.

These methods may not work for everyone, or all the time, but they help many manage their pain—and medication—better.

Doc