My husband takes Tramadol 50 mg tablets as needed 2-4 times a day for his post-surgical adhesions pain. Here's what Wikipedia says: "Tramadol, sold under the brand name Ultram among others, is an opioid pain medication and a serotonin–norepinephrine reuptake inhibitor used to treat moderately severe pain. When taken by mouth in an immediate-release formulation, the onset of pain relief usually begins within an hour."
My question to you is: How do you know it's not helping? Do you take it only after you feel pain and it doesn't do anything? Or do you take it routinely every day irrespective of feeling pain? You may wish to discontinue and see if there's a difference. But you should talk to your doctor about stopping, in case you could experience withdrawal symptoms. Good luck.