I feel for you. Can't have Voltarol either. I'm sure you know but if you are on it often and routinely, get your kidney function checked as well...
The back clinic could be the best option for you, much as you may want to be avoiding it. which reminds me. I much make a telephone call to see who exactly I was referred to...
I never got on with generic tramadol, got the most horrendous side effects from it and it didn't really seem to work. but if it was Zydol rather than generic tramadol, I could take half the dose, get less side effects and actually get much more pain relief and be in a fit state to work! In the end my GP gave in and gave me Zydol rather than tramadol after seeing the difference... spent 15 years on it as well... worked well for my chronic pain from my wrist issues, but didn't touch my back when this first started and currently however, zydol would not touch my pain sadly either!
I wonder what someone coming into cycling would think of the current CC sick list!