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I have nerve pain and understand the feeling of the meds not taking the pain away, and the knowledge that there is a trade off with taking them. I have refused to up my dose, but try literally everything else.
Unfortunately I am allergic to codiene and natural opoids, and so tramadol is my long term pain management medication.
I also take broad spectrum cbd oil and flower, triple strength fish oil for inflammation, magnesium, etc. I have also been using lignocaine patches over the nerve roots after reading a study that showed promising results, and despite it not making any sense to me that they should work topically, it does seem to help.
Besides medications and supplements, I use a TENS unit, IR heating pad, ice packs, massage gun, and positioning to reduce pain on bad days.
I have tried every locally available treatment, experimental medication, therapy, consulted with pain doctors and surgeons. Unfortunately nothing has helped so far.
On good days, I can spend 4 - 5 hours up at most, and will pay for it the next day. Most of my time is spent in a zero gravity bed.
I don't like taking the pain meds, but acknowledge that taking them means I can do more. Push further. It's not a tradeoff I like either, so most of the time I don't.