Kate, CZ,
I have found (after having this Bear on my back since '83), that methadone works well for me. I've been on it since around '90 (I wasn't dx'd for 7 years), there were no fancy, expensive meds back then.

Methadone is not perfect, not for everyone. But, it's the only thing that has relieved "The Burn" for me. I have adjuncts, but that is my only straight pain relief med.
And, for anyone who's out of pocket,
it's VERY inexpensive.

I see so many, on the "medication rollercoaster" and never seem set in their pain relief satisfaction.

I'm not saying that we can eliminate the pain, we can't. All we can do is manage it.
I don't think it will be long before ins. companies start recommending this old med.
It works well, and is very cost effective. (Not what the RX companies want to sell you, so it's not pushed onto, or by, your doctors).

I hope this may help someone, that's just a wish from this old timer...

pete