I tried most of the standard pharma's suggested for PN. In my case it seems to be small fiber neuropathic pain. Undetermined cause, but makes sitting or standing still for more than about 10 minutes quite painful.

I have had minimal benefit and a lot of unwelcome side effects from Neurotin, any Gabapentin-family product, Cymbalta, etc. Frankly, I watch the Cymbalta commercials and would say that my experience was quite the oppposite of what the commercials suggest.

I use tramadol, but limit the quantity/frequency/duration of use to avoid building resistance -- which WILL happen after a few months. Tramadol is a very good painkiller if you understand how to use it. If you take >50mg/day consistently, you develop resistance and may have some unpleasant withdrawal symptoms when you stop.

I recently began taking Mexiletine. Some GI tract irritation but not unbearable at this point (taking a few tums seems to help). There has been some reduction in level of pain, but not huge thus far, but I just started, so I plan to give it awhile as long as the GI issue doesn't become more of an issue.