Jim - If you don't get Cymbalta approved, probably because it is expensive, you might try some of the other meds in similar categories that are cheaper.
I didn't get any pain relief from Cymbalta, tried a whole bunch of other stuff, pain doc recently put me on Topamax for pain. It comes in GENERIC! I don't tolerate anything much, so started on 25 mg once a day(he Rx'd 50, but I usually have to try half a dose first). That was too much, so I was on 1/8 pill, worked up to 1/4 twice a day, where I may stay. At this level I don't have side effects, but I do get some pain relief, so I was able to cut my tramadol from 4 to 3 a day, which is what the pain doc wanted. (Actually he'd like me on 2 a day, but I'd have to start something else to help because tramadol is only good for 4 hours for me.)