hello. have been using tramadol 50 mg since the beginning. for a few years only needed 1 a day then had to up it to 3 a day for many years. only about 18 months ago have had to take up to 5 or 6 a day, some 2 at a time depending on the level of pain. during the day I can kind of ignore the pain if it's not too bad by keeping busy and my mind off it so as not to have to take so many pills but sometimes that backfires on me and have to double the pills to dull the pain. can't win. lol.