I also use my pain management to keep me functional. It really is of little value if i just sit, well i cannot do that, or lay around without pain doing nothing, that seems dumb. I have come to a point where vicoprofen and tramadol no longer help me to be as functional as I like to be. Hate that the affect has warn off. Would switch meds around but i do not feel it will help. In my 66th year I am beginning to feel hopeless that anything much will help. Have had mostly back pain over the years but now my left hand/ knuckles have swollen up, looks like a catchers mit, and has turned quite red and warm. The bottom of my feet feel like i have no padding and am walking on a large rock on the bottom of my right heel! Oh joy, more AS surprises. Sorry to complain so but cannot do this with the family anymore they are sick of it and do not really understand. Thanks for listening.