I've been taking them for about 3 years for my back and they do help the pain a lot, I usually take about 4- 6 a day and can still drive etc - I'm interested that Daffy said about insomnia - I have never slept well and wonder if they have anything to do with that. Occasionally I get a splitting headache, so lay off the Tramadol and take just paracetamol for a day, hopefully on a day when I'm not doing much, as I know that prolonged use of it can cause headaches. It's the only painkiller I can take, I've tried the coedine medications, and they just make me sick.