I have been on tramadol 2 every 4 hours for quite a few years.But the pain with my back and hips at night keeps me awake so my doctor prescribed Butrans 5mcg/hr patches to take every 7 days.He said take tramadol when I need it.I put patch on 7 this evening no tramadol it is 10.15 now and I feel nervy and a bit shakey.I dont know whether to take tramadol as I dont know if I am suffering withdrawal from tramadol.