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           I feel your pain! (Sorry couldn't help it) I have this spinal weirdness going on that is a real combination platter. L-3456 screwed up - then a fracture of C-11 I think- mid back where it is actually leaning on the spinal canal. My doctor is a champ but at a loss what to do . The theory put forth was  functional stenosis, with several other terms- point is I never know when the little monster is going to put me down. Point is I took tylenol 4 for two years and alternated it - with Tramadol 50 mg. X 8 a day. The tramadol beat out the tylenol 4 and even the vicoden  he put me on just recently. Problem is the tramadol you must watch since it takes more for the effect so to speak, over time. But if it's in your system it seems to help (the pain is always there) and it numbs me some from throat to groin and feet somehow. I was so pissed off at one point I took 6 tylenol 4 in front of my wife and all I got was this bloated feeling, trying to make her understand something was wrong with the meds or my body-  I do believe that some of us are imune to certain drugs. I believe that somehow the body percieves it as a threat and runs it right threw intact so to speaak  on a moleculer level. The switching back and forth  was my own attempt to keep from addiction since  I have 21 years sobriety so to speak and I am angry since the whole scenario has me feeling threatened. I did however  see a phsychiatrist to oversee me since I was really getting depressed etc... but for the most part to oversee my behavior becuase of my compulsive nature. I still have horrible insomnia from the pain and general malaise - but try tramadol and alternate aproaches - I am trying to figure out how to clean out the old thinking and go for acupuncture or an alternate- wich generally doesn't sit well with the crusty single headed establishment  but my doc is cool with it.- good luck -B