--you may be inadvertantly contributing to your pain rebounding by going up and down on the Lyrica dosage.

All of the anti-epileptic drugs, such as Lyrica, should be titrated up and down somewhat slowly, so that oen does not get rebound effects due to upregulation. As Billye says, these drugs need to be at a farily constant level to work effectively (if they will work for an individual); suddenly dropping the dose can result in fairly significant symptom uptick as the body, which has upregulated its signalling rate due to the presence of the med, now has no med, or significantly reduced amounts of it, to react against. It's pretty much the same mechanism that happens with a lot of other drugs, even caffeine--stopping them or greatly reducing them suddenly tends to cause symptom recapitulation.

If you don't think the Lyrica is helping, you would probably want to work with your physicans to work out a schedule of gradual reduction, to give the body time to react more smoothly and to prevent rebound symptoms.

I know from my own experience, as I've gradually been reducing my Gabapentin, that if I make too big a drop and/or go off schedule for several hours I will experience "flares". I am currently at 1600mg/day, down from 2400/mg day ten months ago; I am searching for the minimal level to keep symptoms tolerable, but when I do drop, I drop 100mg at a time and observe my reaction to that level for days.