Hi, hemse:

What my U.S. pain management physician told me about narcotic painkillers (such as Tramadol, Tylenol #3, Tylenol #4, Vicodin, MSIR, Dilaudid, Actiq, Duragesic, etc.) is that they can be effective against neuropathic pain but for that, they need to be taken in a higher dose than if they were taken for other types of pain, such as nociceptive pain.