After trying everything under the sun over the last 19 years (some helped for a while, others could not be tolerated or didn't help), I am now using the Fentanyl patch for both my neuropathic pain and joint/inflammatory arthritis pain...successfully, I might add.

Fentanyl patch works better on nerve pain than other opioids. I don't know the reason behind this, but the doctor told me of this when prescribing and sure enough, it was true after just the first few weeks of treatment (compared to other opioids I used before). However, I personally find that Fentanyl does not work as well for joint/bone pain.

My doctor had mentioned Methadone as an option for neuropathic pain, but side-effects are high (according to him) and Fentanyl was a better option for me with severe gastroparesis, which causes GI absorption problems. The Fentanyl, of course, is transdermal and doesn't rely on going through the GI tract.