What drug would be advised if Lyrica (pregabalin) doesn't help? Is it always best to avoid strong painkillers?

Lyrica (pregabalin) I do not know about always, but a steppe approach worth a try. I see your wife has neuropathic pain. Tylenol, (acetaminophen) Motirn. Also consider Capsaiscin or talk to your doctor about a topical anesthetic patch.