As someone who cant take painkillers stronger then tylenol due to adverse reactions - (and unfortuately take quite a few of these with MD knowledge) - maybe its why and what is causing your pain also that may help?

My PN is predominately sensory, and I get the more constant burning, tingling, and aching from that in my legs all the time - I've really found that seems to be their sign to me to rest them - which after couple of days or relief, the intesity will let up sme.. I do have constant and pretty severe pain in my lower back with lumbar issues, and gut (still up for grabs) - but have found that tylenol is necessary at night - as they day goes on and if I keep changing positions my back pain subsides a great deal... and I have some aromatherapy spa gloves that I'll microwave and heat up - double purpose, as I'm letting them "do their thing" I'll lay them on my stomach to get the double benefit of the heat on them - which does help the pain a bit... (heating pads are great but learned the hard way not such a good idea for us folks with pn!)

Anyone else have problems with lidocaine patch???? Are there maybe any that might have less agressive type of med that might help? I was given lidocaine patches for my back - but within about half an hour would be flushed, shaking, heart racing... guess my body was saying, nope... but I've seen other patch type pain killers in drug stores - has anyone found any of these that might be helpful?

ALso, one thing that does work to distract me from pain - I'll put on my MP3 player that is a huge collection of music I've chosen each piece myself, turn up loud and sing... let the neighbors cringe in horror - who can hear em!

I know different methods work for all of us... my neuro says the tingling etc is worst at night cause the nerves are supposed to be at rest and because of the damage they have a real problem understanding that.... finding the right med for this is really a challenge as probably much of the key for a good nights sleep...

Just thoughts, and again, if anyone has found a patch or local rub on pain killer otc - love any ideas.....