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The maximum recommended dose is 400 mg per day, so if using it alone does not provide adequate relief, other medications can be used with Ultram (tramadol) to help manage the pain. For instance, if there is throbbing pain from tight muscles, a muscle relaxant, such as Flexeril (cyclobenzaprine) or Zanaflex (tizanidine) may be beneficial. NSAIDs (non steroidal anti-inflammatory drugs), such as Aleve (naproxen) or Motrin/Advil (ibuprofen) can be added to help reduce pain caused from swelling. If there is sharp shooting pain from the nerves, a medication, such as Neurontin (gabapentin) or Lyrica (pregabalin) may stop the nerves from firing. Your doctor will know the best pain management therapy for you specific situation and may also add physical therapy, chiropractic work, or other non-drug related therapy as well. Patti Brown, PharmD
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