Need help with every day pain

@tisme, very sorry your 'doc' didn't listen to you. Chronic severe ripping pain with no one to help is living hell.

Are you certain that a combination of acetaminophen 500 mg and ibuprofen 200 mg, taken as needed, and OF COURSE not to exceed the maximum listed daily dosage would allow you to get by with that back pain OK?
If you can get Tramadol 25 mg or 50 mg prescribed, it has a lesser if not zero constipation effect, but still is an opioid. Does not have a mood elevation side effect for most people. Other NSAIDs that are helpful with back pain are: meloxicam 15 mg daily (I take it), or diclofenac 50 mg according to dosage recommendations, usually twice a day.
I'm surprised with my bad back (fractured my pelvis in 2023 in 3 places) including 4 bulging discs, one fractured vertebra, two set of vertebrae bone-on-bone), how effective the acetaminophen and ibuprofen are when taken together. The ibuprofen enhances the effectiveness of the acetaminophen.

@laughlin1947 et al
I have Degenerative Disc Disease the full length of my spine and Osteoarthritis in my hip, ankle, and fingers on my dominant hand. I take Tramadol 100mg, 3X day, plus one regular dose Acetaminophen with my morning dose of Tramadol. I take Tizanidine, a muscle relaxant at night, which helps me sleep. Prior to taking Tramadol I took Ibuprofen, and was inching close to 2,200 Mg/day. Taking that dosage of Ibuprofen gave me more pain relief than Tramadol does. However, as a result of long-term use of all that Ibuprofen, I have to be monitored by a Nephrologist to avoid adding chronic kidney disease to my medical record.

I’m aware that Tramadol is a scheduled drug, but taking it as directed isn’t causing me to be addicted to an opioid. It gives me moderate relief so I can function somewhat normally. I’m 78 years old. If I wasn’t taking it, I wouldn’t be able to stand up straight. My primary physician made me sign a pain contract, which I absolutely resented since I was religiously following dosage instructions. I don’t experience any effects with Tramadol that I’d expect if I was taking Hydrocodone or another strong opioid or narcotic. I would take Ibuprofen instead, but I want to preserve my kidneys.

I feel badly for anyone experiencing chronic pain with minimal relief. It’s a lousy way to live. But taking large doses of NSAIDs long term is not good for kidney function, and has to take place under a physician’s supervision. Large doses of acetaminophen can also be hard on one’s liver.

@sjd416
Thank you for responsinding is such detail, I really appreciate that. I'm really very sorry for your medical problems. I too am 78 with multiple back and disk issues, but apparently not as bad as you have it. But that level of Tramadol you take is amazing, because I got a lot of crap from my PCP as well as a PA-C Pain Management Specialist tied to the Newport Orthopedic Institute, and they have had me so worried about even taking 50 mg once a day of Tramadol that I take it and think I won't survive the day.
I do try to keep my doses of acetaminophen and ibuprofen to a minimum each day. I wait until I begin to feel my back ache barely resume, then I take one tablet of each, making sure the doses are 4 hours apart. I'll be getting a blood test in a couple of weeks and see if there is any sign of liver damage according to liver enzymes. I do get to take 15 mg of meloxicam before bedtime. If it helps, I'm not sure, I don't sleep that well, 6 hours a night at best. I doubt that my PCP will refer me to a nephrologist, but I'll need to bring it up to her, good point.
Thanks again for all the info!