I take 3 50mg ultram daily 5yrs for joint pain and when meds start to wear off i'm in a bad mood. what is a more even kill approach or better solution?

Tramadol: Target receptors that include serotonin, norepinephrine and also opioid receptors. Your tolerance is increasing and you may be experiencing withdrawal. Why joint pain at 32? There some investigation and options for you..

Joint pain: There are always option other than pain medications. If you were to be referred to a fellowhip trained interventional pain physician, then with proper workup, you may be a candidate for joint injections with steroid, viscoelastic supplements, or even prp. Talk to your primary physician or look up your nearby appropriately trained and boarded pain physician.