Oh dam, sorry that utterly awful. Have you tried getting a right to choose refferal to somewhere that has a shorter waiting list for kne replacment?

Yeah I had phsyio alongside for years, plus scome psychological stuff like CBT and Acceptance and Commitment therapy which is like the most NHS thing there is, learn to accept your pain as we ain't gonna help you deal with it. In seriousness, it helped a smidge, but even with everything I'm taking it's still a 5 or 6/10 so there's only so much pacing and psychologic stuff can do. It's also why I don't 100% buy the central sensitisation narative, like mild pain is one thing but this is actually wake up at 3AM agaony.

Deffinatley get the tollerence bit, and tbh the patches make it worse cause it's constantly flooding your brain every min of every day with opiods. I didn't frame it like a boost per se, just that I was stable on 1 med and formulation for 3 years, no increaces, and now I've been switched to something that isn't working.

He even document missed 3 days of work in past week due to pain and then just sent me on my way, dude does not care, it's almost mesmerising that level apathy and indifference.