I have taken Pregabalin and Cymbalta for nearly 20 years to manage my MS pain. When I was struggling at work with strong pain that would magnify by noon each day, my doctor prescribed tramadol (in addition). It did help me to get through the afternoon at work, although slowed my speech a bit. It was helpful, although, an article came out a couple years ago warning against the use of both Tramadol and Cymbalta. I weaned off Cymbalta (rough process) but then found that the Tramadol wasn’t enough. (And required monthly visits to a pain clinic). So then I weaned off tramadol (also rough) and resumed Cymbalta. I wouldn’t hesitate to ask for it. It helped me for many months before I was told I had to choose between the two.

Hey jlala, i'm not in the US, but i do have a lot of experiance with opioids; tramadol, oxy's, fentanyl, buprenorfine and currently back on fentanyl-patches. All for extreme backpain due to 4 hernias, stenosis, artrosis and shifted vertebrae. Enough about that. I thought attacking neuropathy would be easy-peasy, with this amo. But nothing. I actually asked my neuro about why and he said that a tramadol trial was first done some 20years ago and the outcome was that the pain indeed seemed to lessen, but more or less the same as gabapentine and pregabaline. However, side-effects were less. I didn't pay much attention, for i was no longer taking tramadol. Because of your post, i actually searched for the trial he was referring to. Its in dutch. But in the end, they didnt know why tramadol seemed to work, a little, ( 45 to 55 % noticed a change for the better) neuro did say that oxy and similar drugs influance the brain, the way pain is recieved and processed. I choose not to continue gabapentine, it didnt work and im one of 1 in 20 or so, who experience insomnia side-effects. So, tramadol doés work somewhat for some people. It can make you feel nauseous. Me at least. Good luck