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A 3rd choice would be a "muscle relaxor" like cyclobezoprine (flexril), or Carisdpool (Soma)
These actually go in and relax the muscle, or muscles that may be casuing tension to the problem area.
If Ultram does not work, your next choice will probably be a type of antinflamtory to see if it works. And if it doesnt you will probably be put on a muscle relaxor next.
Narcotics are the last thing you wanna be on, but soooo many doctors are such quacks they over prescribe the shit just to get people out of the office with that magic pill hust so they dont come back having to go through the proper trial and error needed to find what works best
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