This is Dr Basu, experienced Internal Medicine Specialist.
I am here to address your concerns and provide great service.
Flu or viral infection is most likely given the diarrhea, shivering spells.
Tramadol can cause serotonin syndrome rarely.
With few doses it is very unlikely.
Still, the symptoms should improve since tramadol has been stopped.
Loperamide ( imodium) can be taken to stop the diarrhea.
Also plenty of fluids, soup, bananas, rice, toast will be helpful.
Regarding back pain, it is better to consider a muscle relaxant like Baclofen.
Also further evaluation with spine xrays recommended to rule out any compression fracture.
Opiates like oxycodone also may be tried for better pain control.
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