Tramadol really helps me with pain, but I only take it very occasionally. I am very sensitive to it, and have to use 1/2 of a 50mg tablet. It will work well into the next day at that low dose for me. A whole one makes me "hallucinate".. I call it "tripping".
But when I do take 1/2 when I have alot of pain it does work for me. Too much walking or too much gardening, sometimes sets me off.

I don't have severe pain from my PN anymore (it was severe when my thyroid was low). I have aggravating discomfort, and sometimes terrible burning. (but since watching the foods that trigger me, the burning has become less).

I still have Lidoderm patches and Salonpas. And Biofreeze. I used the Biofreeze last night in fact.

For aggravating pain I also use Tylenol or Aleve liquigels for that, but not every day either and I rotate them, so I won't get any long term negative side effects, since Tylenol can affect the liver and Aleve (NSAID) can cause heart attacks or stroke.