I wish i knew the answer tothis one. I can only commiserate with you. Seems like mine has been in flare since may-june. I finally, today, called my pain mgt dr for an appointment. He's not available for 3 weeks!!! I'm hoping there is something he can suggest. I dont find tramadol helpful. Others take lyrica. Sometime a change of scenery helps me feel better mentally. Pain is still there but i dont let it consume my thoughts. At least i get satisfaction of doing something different so im not as depressed as i would have been if i stayed home focusing on how crappy i feel. I cant stand staying home day after day after day. It feeds into the depression. So take a shower, get dressed, go for a drive, visit a museum, see a movie, eat cake. You will still have pain but you are nuturing your soul.