When you have been on the same Medication for such a long period of time, many times you build up a tolerance to your medications. That's what happened to me after I was on Norco (Hydrocodone) 7.5 for 7 years. After that length of time they just quit working on me! :( My PM Doctor switched me to percocet
10/325's for my BT (Breakthrough) Meds along with giving me a Long-Acting Med and that took care of the problem.
Hopefully, the Ultram will give you some relief.