I have been getting by using buffered aspirin and extra-strength Tylenol (generic) for pain (along with Neurontin). But I have had a couple of blood tests that show elevated liver enzymes (a danger signal for Tylenol), and my acid reflux problems limit the amount ot NSAIDs I can take. I'm a little nervous about getting started with narcotics, and I understand that although Elavil can help with pain (and sleep), it also tends to cause weight gain, which I'd really like to avoid. Complicating this picture is the fact that I'm taking Avonex for my multiple sclerosis, and my neuro told me on Wednesday that Avonex sometimes causes elevated liver enzymes. I talked to the Avonex people this morning, and while my neuro was correct, it's also possible that the Avonex alone wouldn't cause the problem, but that it might in combination with Tylenol. In any case, all this leaves me in a quandary about how to handle pain. If it's just the low-level aching that I always seem to have, I usually can manage without taking anything, but I've had a lot of pain in my arms (especially right arm) lately. Nothing really seems to help, that either. It feels muscular, not neurological, and though buffered aspirin or Tylenol sometimes dulls it a bit, the pain returns in spades if I move my arm the wrong way. I'd really appreciate some ideas I can float with my doctors in considering my alternatives. Thanks for whatever suggestions you can share. --Laura R.M.