my pain management dr now has me on 2 tramadol 50mg 4times a day and balacet 325mg every four hours. it's only been a week and it seemed to help some at first, but not anymore. he said we would move up the ladder and i guess that's how we will find what works. I took cymbalta and it helped with the pain but i had severe nausea. also took lyrica which did nothing.