Do I need pain management for Tylenol 4 with codeine and the muscle relaxer Soma? I have scoliosis in my back and muscle spasms and also cyiatica. I have lyme arthrtus which I have had for years. My family doctor has been prescribing these medications for me. He told me today a list was coming out July 1 and I would have to wait and see if these medications require pain management. I am 60 years old ad my back is rounded so bad I cannot stand straight.