Hi Elaine,
A friend of mine takes tramadol when the pain is bad but divides her dose taking it in two halves a couple of hours apart in the morning. She finds doing it this way helps to avoid a sick feeling. As a nurse, I trust her knowledge and judgement but always best to ask your own practitioner or pharmacist for their opinion and advice.
I still only take paracetamol and occasionally ibuprofen but I probably need tramadol. My doc has offered Meloxicam in the past but I've not used it - anyone here tried it for fibro or arthritis?
Best off luck with the meds,
Joo x