"i just got into pain management. i have cubital tunnel and degenerative disc disease in t3/t4. my doctor put me on 25mcg fentanyl patches and 50mg tapentadol(nucynta) for breakthrough pain. the fentanyl is helping but when i take the nucynta it doesn&#039;t seem to help my break through pain. my doctor was excited for me to try it and see how it works. "