Gabapentin and tramadol are both used for nerve pain, but they work differently. Gabapentin is an anticonvulsant that calms overactive nerves and is generally preferred for neuropathic pain due to its targeted mechanism and lower risk of addiction. Tramadol, an opioid-like pain reliever, can help when pain is severe or not controlled by other medications, but it carries higher risks of dependence, tolerance, and side effects such as nausea or dizziness. Overall, gabapentin is usually the safer first choice for chronic nerve pain, while tramadol may be reserved for short-term or breakthrough pain under close medical supervision.