Most of us are quite a bit of heavy-duty painkillers and muscle relaxers and have tried quite a few things. That doesn't mean that it has to get to that, as many people get fixed by physical therapy and this cortisone shot. Usually you try the least invasive techniques and move-up. Get to a good doctor and a good pain clinic as well

There are two components to pain management and the most important is the hunt for the cause and cure. In your case it sounds like there are two problems-autoimmune and spinal. Sometimes cortisone shots can help spinal pain and physical therapy and that's all you need. Sometimes it requires surgery and sometimes you never get rid of the pain completely. Autoimmune problems are complicated and there are all kinds of drugs with all kinds of side effects. Seeing a good rheumatologist and a good neurologist and orthopedic specialist might help.

The other component is managing the pain while you are searching for a cure and if you don't get one. Usually start with the least invasive techniques like physical therapy. Many people I fixed by physical therapy or may be a cortisone shot in the spine are a few. They are trigger shots acupuncture and other treatments. Many of us are on quite a bit of drugs and that can help you get through the process of trying physical therapy and other treatments and sometimes that's the only solution you get, so it ends up being a permanent answer. The types of drugs that many people are on includes long acting opiates, muscle relaxers, anti-seizure drugs (for nerve pain) and antidepressants (that can help with pain not just depression).

The long acting a short acting opiates do a lot to keep the pain under control. Of course, they do causes dependency and they do have side effects. If you can get by with liddoderm patches that's better. Special compounding pharmacist can put lidocaine and other drugs in topical ointments, so you can get to spots that the patches don't get to that well.

There are many autoimmune diseases and for some of the more serious diseases like Lupus or MS, there are some very heavy drugs that can stop the progression of the disease or help with the symptoms. They do tend to have side effects although they usually start with the ones with the least side effects.

It's a process of figuring out what works for you and that could include rest or exercise or specific exercise or a better pillow or better chair. Hopefully you'll get an answer but if you don't it's a lifelong process of, making the pain is bearable as possible and reducing it as much as possible so that, you have as much of a life as you can. It's about adapting and there is life after chronic pain, so hang in there and keep looking for answers.