I also get breakthrough pain and was prescribed tylox with my oxycontin. Now he never told me to take just the oxycontin or just the tylox but both together as you were told to do. Neither works as well without the other. What really helps with the breakthrough pain is a drug called ACTIQ, it's 400 mcg fentanyl base and helps extremely well with the breakthrough pain. It comes in a lollypop form and when that old pain comes popping through I have to sit (even in Wallmart on a swing) and suck on my lollypop. It really helps with the highest level of pain.
Love,
Helen C.