I've done a lot of post on it over the years, both here and on DINET. Never could figure the exact science of why it helped as it has so many properties. You might like to do a search and see those possible connections.In which way does the Tramadol help you?
As to how I felt and how it helped POTS, calmed down my autonomic nervous system, balanced out my moods and took a very slight edge off pain. We are talking of 1/4 to 1/2 of the lowest dose available and only 1 to 2 times, if needed. And rotating on and off, as you build a tolerance and it stops working. Many just would up their dose, but I wanted to not get addicted and have a smaller amount keep working. And when real bad a Bentyl added. But it had a tendency to cause depression as it not only worked on pain and muscle spasms, but helped a bit like an anti-anxiety medicine would. Tramadol, before it was put into the opiate category and classed, was also being used off label for those with bad or no response (treatment resistant) to SSRI or SNRI. It works on all the neurotransmitters and NMDA (glutamate) and opiate receptors. It also has a mild calcium channel blocking affect and there seems to be issues with that channel with both POTS and MCAS. (My Emergency MCAS medicine, when I don't get on top of it fast enough, is GastroCrom and it too has a mild calcium channel blocker affect. I no longer use antihistamines. See post on MCAS.)