Hi, Noted your history about shoulder replacement surgery, taking hydrocodone with acetaminophen and tramadol and another problems of severe chronic low-back pain and twitching of the lower jaw making troubled talking and grimacing. Obviously all the three things are not correlated hence let us discuss one by one. The twitches in the lower jaw are called facial tics and is due to stress, anxiety in most of the cases wherein there is uncontrolled discharge of nerve impulses in facial nerve. A proper clinical evaluation, MRI study of the facial nerve, nerve conduction studies and treatment with medications like Amitriptyline will control the problems. About the severe low backache: need a clinical evaluation, examination and MRI of the lower back to get the cause and get treated accordingly. Try to reduce the dosages of painkillers and shift to NSAIDS or so as per requirement. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. T Chandrakant, ENT & General Surgeon