Would there be an advantage of using tramadol over butalbital with codeine for upper back muscle spasm pain and headaches? would it be safer?

Pain meds: all drugs have safety profile and side effects, and Doctor use which drug that will help the patient with least side effects .check with your doctor

It may help: Yes, it may help. The way tramadol works is different than than other two. Therefore, it may target pain through a different receptor. I would also consider adding a muscle relaxant such as baclofen