Hello. I Am A 25 Year Old Male (Wt About

Hello. I am a 25 year old male (Wt about 168Kg) status 5 years post gastric banding suffering from myofascial pain syndrome with some cervical spondylosis. Lately, I have been getting a lot of occipital and thoratic/lumbar pain and a little bit of kyphosis pain is 9/10 and with insomnia. My Pain Mgmt Physician and Primary Care have tried almost everything. Insurance is making it difficult to get transdermal creams. Muscle Relaxants: Flexeril 10 TID, Baclofen Max 80, Metaxalone (800 TID), Carisoprodol 350 BID, Robaxin 1 gram TID, Orphenadrine ER 100mg BID. TCAs are contraindicated due to SNRI and Bupropion interaction. Already on Clonazepam for anxiety and insomnia (tapered to 0.5mg qhs). I am getting trigger points regularly. Physical Therapy contraindicated in pool due to decubitus ulcer from denim pants, I already have an NMES unit and am on Hydrocodone (tramadol/Tapentadol/gabapentin/TCA contraindicated. Steroid Sensitive). Is there anything we are missing?