"i&#039;ve found that nucynta (palexia in europe) has been a great for me.  i&#039;ve had lumbar pain on and off for 35 years.  for the last seven years it&#039;s been chronic, sometimes incapacitating.  i was on the hydrocodone ladder (5, 7.5, 10), (x4, x6, x8,  per day) until a doctor where i work said &quot;whoa!  that&#039;s way too much acetaminophen.  it&#039;s dangerous.&quot;  he prescribed tramadol.  it helped somewhat - and had an upper limit (for me) of about 300mg/day before nausea set in.  a year and a half ago he suggested i try palexia (the trade name in europe).  what a difference it made!  some tolerance (not much) and no dependence i can discern, nothing like the &quot;codones&quot;.  easy to lay off it whenever.  for me it&#039;s great!"