<human>: I am experiencing acute chronic upper back pain in muscles from spine and around the ribs to under my arm. i have some arthritis in the area but normal everyday activity can trigger off pain . I have pain medication from doctor tramadol but it takes 4 hours to work. I may be pain free for ten minutes or hours or for days. the last 5 days seem be needing Medication every 4 hours but its not giving much relief. I don t know how much more of this pain my body can take. please advise on some stronger long term relief. R osalind
<bot>: Hi, Tramadol is an opioid analgesic used to treat pain in rheumatoid arthritis. It can be used for long term, but there are higher chances of its physical dependence. In acute cases for immediate relief you can take NSAIDs. But for the long term relief other measures should be taken too like:Heat or ice to reduce pain and stiffness. Exercise to stretch and strengthen the muscles of your back, shoulders, and stomach. Physical therapy to help increase your flexibility, strength, and balance. Your physical therapist may teach you an exercise program, so you can do it at home. Massage to help reduce muscle tension and pain and improve blood flow. Steroid shots to help reduce swelling and relieve pressure on nerves and nerve roots. But there is little evidence showing that these shots can help control back pain. Do consider positive feedback as a credit to my work Let me know if you have any further questions.