But I think we've already discussed this.

With the increase in Neurontin, comparison of the other two
drugs (Elavil + Lexapro) changes. The Elavil may be redundant, or not much of a benefit compared to use of Ultram.

It is worth trying Ultram (it may not work for Jess anyway), because for pain, it is less constipating and since this is her
weak spot, needs to be addressed. Elavil CAUSES constipation you know. Elavil in very low doses doesn't do much anyway for serotonin levels.

Also another alternative is to use magnesium instead of the Lexapro. Magnesium will help spasms, and tight muscles as well as have a minor laxative action.

So alternatives involve changing the other two meds which provide little in the way of relief.

And the bottom line is that both Elavil and Lexapro are low dose and less of a risk than if they were high dose.

Stopping Elavil should not be much of a problem. Stopping the Lexapro may cause withdrawal symptoms. At low doses it is less likely, but length of time on it also enter into any discontinuance symptoms.

I think this experience is rather typical. Many pain doctors appear to be cold...that is all they hear all day long.

And I would also add, that you should LOOK like you are in pain when you go there. Putting on make up, and dressing up for the visit, makes it look like you are not suffering so much.
TOO casual, or unwashed may also put doctors off as looking like a drug seeker. So something inbetween should suffice.

Let's hope the PT works, and this all will be short lived anyway.
Using the magnesium may really help, so I would try it.
I have a magnesium thread on Vitamin forum on page 1.