Several things are a big help for breakthrough pain.

1. Believe it or not, two Alka Seltzers give the pain relief of a good dose of morphine, without the constipation or dopiness. Alka Seltzer is aspirin, citric acid, and heat-treated baking soda. The soda/citric acid mixture dissolves the aspirin, and the treated baking soda causes the dissolved aspirin to enter the blood stream almost as quickly as if injected. The pain relief occurs within minutes and lasts for hours. As a bonus, this way of getting aspirin doesn't cause stomach irritation or bleeding, is good for your heart, and reduces the risk of several types of cancer. The side effect that stops me from using it more often is tinnitus. I always have a good supply on hand, and use it probably once or twice a week.

Follow instructions on the label. It won't stop nerve pain (not that anything short of massive opiate doses does), but it takes the edge off and allows sleep.

2. Lidocaine skin patches deaden an area effectively for about 4 hours. The lidocaine gets deeper than you'd think. I used it for extremely painful muscle cramping in my shoulder caused by a ruptured cervical disk, and it killed the pain even beneath my shoulder blade.

There are lidocaine salves which work similarly. These are by prescription only and not for daily long term use.

3. Pulsed micro-electric stimulation of the area interferes with pain transmission and reduces pain for a time. After twice daily use for a few weeks, it will reduce pain for 24 hrs after each use. After daily use for months, it will reduce pain for several days. Unlike items #1 and 2 above, pulsed micro-electric stimulation promotes nerve and muscle healing and retrains your nervous system to restore normal reaction to nerve ending stimuli.

The latest and greatest is "interferential electrical stimulation". My physical therapist uses it, and it's very effective. I've also had great relief with the similar, but overpriced "ReBuilder". Use the search function of this forum to find out where to buy and how to these units.

4. Opiates don't kill nerve pain except in very high doses. I used big doses of oxycontin for the disk injury. They stopped the shoulder pain which allowed four hours of sleep (the lidocaine patch gave another 4 hours), but had NO effect on my PN pain. A bigger dose of oxycontin or stronger opiate kills all pain.

Opiates are relatively safe, don't cause dopiness if the dose is appropriate for the pain and have minimal serious side effects. The opiate side effect of extreme constipation make them for occasional use only for me. Still, they're handy to have on hand for emergency use.

5. Cold is worth a try. For neuropathic feet, put your feet in an Epsom salt solution of cool water. Add ice cubes to make the water gradually very cold. Since cold shuts down nerves, you should feel no discomfort if the cooling is slow enough.

Keep your feet in the cold water for about 20 minutes. Then, let the feet warm up naturally, i.e. do not apply artificial heat. If this helps you, it should give relief for several hours, and is good for the health of your nerves in the area since fresh blood floods the area when the cold is removed. You can do this as often as you like, up to hourly.

Epsom salts are magnesium sulfate. The magnesium absorbed through the skin helps calm nerves in the area and reduce pain.

6. Supplement with a high quality calcium/magnesium formulation, about 1000 mg. of elemental calcium a day, 500 mg. of magnesium. Magnesium calms the nerves and relaxes the muscles. Good formulas are mixtures of mainly organic, chelated, or acetic salts. You need supplemental vitamin D, about 1000 units, to utilize the calcium and magnesium. Use the search function of this forum for a lot more about magnesium.

7. Marijuana reduces nerve pain dramatically for about 8 hours. Blood levels build over three days of use, so reduce intake on days 2, 3, and thereafter. The side effects are dopiness, inability to safely operate machinery, weight gain from the "munchies", and the risk of zealots putting you in a cage with criminals for long periods of time.

Oh, and forgetting what you were talking about.

Seriously, a cousin of mine got throat cancer from years of daily use (he didn't smoke cigarettes). In spite of what advocates claim, pot is addictive. I had a tough time stopping myself about 35 years ago and have seen addiction in others. Like a sober alcoholic, I don't dare go near it, but it is relatively safe if used judiciously and if you avoid law enforcement.

Your kids can get it for you.

8. Meditation is practice in directing the attention away from where you don't want it to go. After six months of daily guided meditation practice, mediators have a much increased ability to deal with severe pain, as opposed to the severe pain dealing with them.

Meditation, healthy diet, supplements, and exercise (including yoga and tai chi) are more of a long term fix, but all help, and all work together to make each other more powerful and get the breakthrough pain reduced to tolerable levels.