Surely you need long term pain management plan as u r suffering from many ailments all of which are chronic. In my opinion there is no connection between spinal stenosis and migraine. But apart from pain killers you need something else which will help u deal with all these conditions in a better way...and that is Vipassana meditation. Do read about it and spend 10 days of your life learning Vipassana....it will change your life and will help u surely.