Fibromyalgia & arthritis & pain levels are very high with 8 mg. of exalgo, 1500 mg. of gabapentin & 1 to 2 tablet of tramadol 3 x a day. any thoughts?

See details: You are already receiving multiple pain meds including a morphine derivative. Your Gabapentin dose is a little on the low side. You do not list prior meds such as Cymbalta or savella (milnacipran) which are possibilities if they have not been tried previously. It never hurts to get a 2nd opinion.

Different medication: Have you tried any (or all) of the medications for fibromyalgia. Lyrica? Cymbalta? Savella (milnacipran)? You may benefit from an anti-inflammatory medication for the arthritis.