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Its a Pain med, but one that is used in SIMIALR situations a non sterodial antiflamitory pill.
Its designed and specialized for chronic pains.
Like arthritis, and sports injuries.
You say its your back?
If its not doing the job, the key is not to take more in hope it will work. The answer is to get a new med.
There are so many, including the non-sterodial anti inflamtorys I mentioned. Talk to you doc, tell him this shit aint working, and you need something else. In the mean time stop taking it and take 6 advil every 4-6 hours. See if that is better. If it is tell the doc you saw better results taking 3 advil than the ultram as directed.
It will put him on the right track to prescribing you something in the proper family
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