I have fibromyalgia, and always hurt. I've had 5 shoulder surgeries, and am bothered by pain in those as well. I also have tendonitis in my elbows and hands. I feel better and more alert when I take tramadol. I also take sertraline. Are there any long term health issues I should be aware of? I don't really have any of the side affects listed. I don't know what else to do, because I feel better when I take it.