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The FDA approves the drug for the treatment of moderate to moderately severe chronic pain in adults such as back pain, fibromyalgia, and so on, which is the most well-known of the Tramadol uses. The drug itself has no activity on opioid receptors but instead works through the actions of one of its major metabolites O-desmethyl Tramadol. This activity at opioid receptors is the primary mechanism behind the analgesic properties of the medication. The parent drug also inhibits the reuptake of norepinephrine and serotonin, contributing to its analgesic properties.

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