Ive had so many different medications and procedures in hopes to try to manage this horrible pain due to a syrinx. Nothing has worked. Im currently taking 300/day lyrica which doesnt do much at all and 400+/day tramadol. The tramadol is okay at best. Im really trying to not take heavier opiates as I did in the past but they seem to be what worked best. The problem that I have with any medication is that after a while, I have to take more to achieve the same result. Yes, this is called dependence. I just dont know where that comfertable in between is. I'll take anything once to at least see what benefit it may have. The worst time of day is 6pm-12am. I havent slept good in over two years. I'm just so tired of this. I cant beat it. The Dr.s at the NIH said "2/3 of the people with SM experience high levels of pain years later. Thats hard to swallow. When you have a knee injury, the doc says "in 8weeks, you'll be on your way to recovery." I/we dont get that kind of recovery schedule. That sucks. I know that theres no miracle pill for this but im thinking that i might ask for a patch again. im really out of ideas. help.