Hi Ed,

Sure, there are a lot of other analgesics that can be prescribed. Which ones depend on your condition(s), medical history, and other factors. Analgesics are not generally the firstline medications prescribed for peripheral neuropathy (usually gabapentin, Lyrica, Cymbalta, or Topamax, but others as well) but often are in conjuction with non-analgesics.
http://www.mayoclinic.com/health/per...ents-and-drugs

I'm not sure, but it sounds to me like you're describing an increasing tolerance for tramadol. Tolerance can occur with any kind of analgesic; how fast depends on your metabolism. This should not be confused with addiction.
http://drugs.about.com/od/mdrugandme...erance_def.htm

These are matters to discuss with your doctor(s) to make some kind of change if warranted.

HTH,

Doc