i'm sorry the doctor gave you tramadol! Tramadol is a SNRI,5HTA2c antagonizer, NMDA antagonist, opioid agonist. i'm not going to say it doesn't work or anything like that because i'm sure theres a lot of people who it has helped that will love to correct me on it.(my partner gets relief from it, he is really sensitive to meds, but gave him horrible side effects) but for pain...ehhh give it a few days to kick in work up dosages then possibly. for immidiate pain relief (shaking head) the doctor should have given you something else. if you were in that much pain to go to an urgent care clinic then you are in that much pain to be on a narcotic at least for the initial onset. and if it is a muscle strain an anti-inflammatory would do some good too. but that's just me. 20mins of ice every hour is all i can tell ya. sorry for the pain i understand physical pain oh to well.