Tramadol (Generic Ultram) is a new type of non-narcotic oral pain medication that can be prescribed to treat low back pain. Tramadol acts centrally (in the brain) to modulate the sensation of pain and has no anti-inflammatory effect. It is a stronger pain reliever than acetaminophen, but probably not as strong as the narcotic agents. Tramadol is often a good option for treatment of low back pain because patients do not build up a tolerance with extended usage and there is a very low incidence of addiction. The regularly prescribed dose is one to two 50mg tablets every four to six hours, not to exceed eight pills a day. Exceeding the prescribed dose may lead to respiratory depression or seizures.