David - Just a note on the Lyrica - sounds like you are hoping to take it like you would advil for a headache (relief from a single dose). I want to make sure you are aware that this is not how Lyrica works (from personal experience and conversations with my neuro). Lyrica can actually take 6-8 weeks to work fully within the body. For me when I first started taking it the effectiveness seemed to fluctuate and my doctor told me that yes that can happen. I have been on it for 6+ months now and the fluctuations are fewer and farther in between. It might work on first dose but there is a good chance your body will need to adjust for it to work fully. Also as far as side effects - day 1 and 2 of Lyrica I was pretty spacey and out of it but that definitely subsided. I still struggle with occasional bouts of sleepiness/brain fog feeling but not always and I am working with my doc to see what we can do about that (dose adjustment perhaps). Hope this helps - good luck to you!

Boiler, thank you for your note. I appreciate it. And you're certainly right. I was aware of this, so I won't be expecting immediate relief. I imagine my body will work similarly to yours and take some time to adapt. Perhaps my words were misleading, but believe it or not it can takes months, certainly weeks, for me to get in to see my neuro, if the pain comes on intensely, so I was thinking of such a timeline, and thought it would be better to get started immediately, if it came to that.

Thanks also for addressing the side effects of Lyrica. That's good to hear. Unfortunately, my brain is my meal ticket more than in most jobs, so I have to be careful and try to maintain optimal cognitive function, and as things stand for a few years now I've felt cognitive decline, which is troubling. I'm hoping to reverse that, but perhaps that's too optimistic.

I would say similar for me - I work as an engineer so the brain is definitely a necessary aspect :) I understand what you are saying now about better to have the Lyrica on hand - just didn't want you to be surprised or give up on it too soon due to lack of effectiveness.

Ah yes, engineers do need their brains!

Right. Yes, well, I'll give it a chance, if it gets to that. And I don't mind tuning out, but I can't work if I'm always out of it. :)

I wouldn't recommend this under usual circumstances but with sfn I think you need to be prepared. Tramadol - I take it only when really desperate. It kicks in for me in half hour and you have 24 hours joyous relief. I then won't take it again for another week, two weeks maybe. You will already know about the addictive risks associated with this. The good thing is you can take it as and when. It hasn't caused me any problems at all. I just wish I could have it every day as it also makes me feel good and have some energy and I feel better all round on the days I have it.

I agree here with Joanna. As much as it horrifies me to say this (I am someone who has lived my life being anti-drug, holistically, and a health and fitness nut).
I must say... I'd prefer to have narcotics to take for when the pain is absolutely unmanageable then to be on a daily med. I have been dealing with excruciating nerve pain for 2 years now. I tried lyrica, neurontin, flexeril, zanaflex, cymbalta, baclofen, and could tolerate NONE of the side effects, nothing touched my pain and some made my autonomic problems worse or caused emotional problems. As much as I still DESPISE to put a pill in my mouth, I thank the universe for having short acting pain meds that break the cycle and keep me out of the ER. In the beginning I was terrified of addiction, becoming dependent, etc. After 2 years, with much relief, I can say that I still only need 1/2 to one pill to break the cycle. Once I take it, I rarely have to repeat the dose in the same day unless I'm in a very bad flare. Sometimes I can go a few days and not need to take anything.

I take Gralise which is time released neurotin. I take 1,200mg a day before bed so I sleep through the side effects. The down side is it's expensive and took me over a year to get the insurance company to approve it.

I tried Lyrica and would have considered taking it I just didn't have the time to fight with the insurance company to get the stronger dose approved. At some point I will try it again, when I have to time to fight the fight with the insurance.

Thank you all for your input.

Joanna, I appreciate the importance of the point you make. Is Tramadol the one to go with? Healthgirl, is this the one you use too? I can certainly ask for a prescription that I can then have on hand and fill in case things get very bad. This is an important point. I'm trying to keep it as pure and natural as possible, but if the pain gets excruciating, perhaps it's best to have something on hand rather than head to the ER and waste an entire day.

Mike, thanks. Unfortunately I have to stick to the cheaper options, if I do take anything, since I may not be able to have many or perhaps any meds covered, and may have to pay out of pocket.

Hi David, yes I'd say tramadol is the one to go with. I got the prescription in and ensure there is always some in the cupboard. It really is the thing for the days you don't think you will get through pain. Unlike Gabapentin and all the those types you don't have to worry about taking it all the time or missing doses. For me it is seductive, I have a better day all round on it and sometimes the day or so after I miss it. That's the psychological draw of it to be aware of. It does just provide an extra bit of happiness!

Thanks for this suggestion. I'll look into, likely get a RX and have it on hand. Does it have any side effects? Does it cause constipation? Isn't that a thing with such meds? Other than the addition issue that one needs to be aware of of course. Also, does it completely take your pain away? If so, does it leave you numb mentally? I would need to be aware all day, that's the problem. And it sounds like it lasts all day, or 24 hours. Sorry for all the questions, but it's always better to speak to a live person who is taking it rather than read about it online, especially when that person has symptoms similar to your own. :)