Tramadol is an accepted treatment for the pain of RA. It is a synthetic opioid analgesic. Some consider it safer than anti-inflammatory drugs for older people. There is less a risk for cardiac problems and for stomach bleeding. Dr. R prescribed Tramadol for me three months ago when I was having pain problems. I am on 50mg every 8 hours. It definitely helps me. It is odd but I feel better on it. I have more energy. My pain levels are better. When I started it I was careful about driving. Now I take it when I get up, in the afternoon and in the evening. There are no issues with being drowsy. It is the opposite. I think more clearly. There is less of the methotrexate fog.