"for 20  years i had been taking pain medicines (from vicodin to norco) for acute pain (blown out knee, two knee replacements, torn rotator cuff) to chronic back pain due to 4 herniated discs and a chronic fracture at t11-t12.  it got to the point where taking 6-7 norco 10/325 a day didn&#039;t keep me comfortable. my ortho sent me to a pain management clinic at the local hospital where they switched me over to butrans. i was started on the 10 mg which helped, but i was still in discomfort. the following visit i was switched to the 20 mg.  i am very satisfied with the level and continuity of pain relief.  what a godsend!  my only complaint is that the patch seems to lose it&#039;s effectiveness by day 5 or 6."