I have been taking Darvocet since April and it was doing an ok job until this shoulder and arm flare up that has been going on for weeks. I have an appointment with the ortho doctor to rule out any shoulder problems....next thing it could be is my neck. What pain med is a step up from Darvocet? I stopped the Ultram ER back in April because of bad side effects so that drug is a no no. I don't want to move up too fast on the pain pill ladder because I know later on down the road there will be a need for stronger med's.