Thank You. I Have Been Prescribed Tramadol 50mg Plus Paracetemol

Thank you. I have been prescribed tramadol 50mg plus paracetemol at a dose of two tramadol with two paracetemol four times a day, for the past four months following an arthroscopy and right knee replacement within three weeks of each other this July. At this stage almost 20 weeks down the line I have been trying to reduce the pain relief with horrendous side effects. How long can I expect to encounter these. Many thanks