What treatment discipline follows pain management specialists?

Seems like the logical next step would be to see either a physical medical and rehabilitation (PMR) doctor or a spine orthopedic surgeon. An epidural steroid injection is a fairly conservative treatment that might give you some relief from your pain.

Yes, I was thinking a spine neurosurgeon would be the next specialist to see. I wait to get a recommendation from the pain management doctors I've been seeing, but they seem to only want to prescribe some type of pain reliever.
As for epidurals I have had several of them over the past 3 years and the duration of pain relief has been very short each - 2 or 3 weeks at best. The doctors usually just say to come back to them in 3 months for another epidural. I wish it were that easy. The back pain resumes in a matter of days. A few days ago, I got a lower back "more precisely directed" injection (4 shots in a small area) that has now dissipated in terms of benefit.
It seems I'm headed for minimally invasive spine surgery, but there are several options there...Different Types of Minimally Invasive Spine Surgery, as follows: Microdiscectomy; Cervical Arthroplast; Minimally Invasive Laminectomy; Minimally Invasive Laminotomy; Percutaneous Fusion; Kyphoplasty; Minimally invasive scoliosis correction. I think I need to head to another hospital-based spine institute with a full staff of doctors and specialists.
Many thanks for your reply!

@laughlin1947
You are on the right track. You need to find the exact cause of your pain not just just throw pain meds at it.

I had a MILD done last year but onlt helped left leg some and right leg not at all.
It was worth the chance, the surgery is a fairly easy one and it confirmed my stenosis pain is foraminal and not central.

Due to adult scoliosis there is really no other solution for me than a fusion to fix.
Bones vs. nerves bones always win.

Below is a link to the best explanation to fusions that I have found, it explains everything quite well. It is a little long but is in plain english and a good read.
https://tinyurl.com/4br244ps

Thank you very much for the link explaining spinal fusion - long article but very informative. I do not know what MILD entails, but although I do have some walking problems, it is more related to overall muscle weakness than other problems. My right leg does bend readily, so walking down sloping sidewalks, etc. cause it to stiffen up and not bend.
At my age of 78, I expect to have knee aches most of the time. I can get hyaluronic acid injections for my knees that work well. Since I have that 23-degree scoliosis, I am thinking more and more that a fusion fix is in the cards for me. But I have quite a few vertebrae that are messed up, although the several bulging discs are not terribly extreme. I get frustrated that the pain management medical people didn't review in detail the two MRIs of my spine and immediately recognize my condition was eventually going to lead to chronic lower back pain and that a consistent series of epidurals was not the answer. I've never had an epidural that gave relief of my back pain for more than 2 to 3 weeks, often less. Thanks again for your response.

MILD stands for minimally invasive lumbar decompression.
Fancy name for a roto rooter around the central nerves that go down the middle of the vertabre to relief any pressure that is on them.

Hopefully you can get in to see a spine surgeon and they can get you on the right diagnostic track.
An MRI doesn't show pain it is just a diagnostic tool.
Always get a 2nd or 3rd opinion and do your own research when it comes to surgery.
Once you have a fusion you can't go back and undo it.

I suggest seeing a Spine Physiatrist. I have been seeing one for the past year and it has helped me a bit. Best wishes!

So what is that therapy like? Is it specialized physical therapy targeted at scoliosis or something else? I have 2 separate sets of vertebrae that are bone on bone, so I think physical manipulation of that part of my spine is only going to cause me more pain.

@laughlin1947

A spine physiatrist (Physical Medicine and Rehabilitation doctor) specializes in non-surgical care for neck and back pain. They focus on restoring mobility, diagnosing nerve and muscle damage, and managing pain through physical therapy, medication, and image-guided injections, often helping patients delay or avoid surgery.

But not all are the same, the first spine physiatrist I saw said "just wear a back brace" - the current one is targeting the spine and facet joints and it's helping.

@laughlin1947 once recent MRI, CT studies are done then either one or both a neurosurgeon or orthopedic surgeon can do the job. I’d be sure to get a second opinion too. At 74 I too have scoliosis 22 degree lumbar right and 20 degree thoracic left plus OP, OA and multiple disk bulges of both spinal areas. I had fusion L4-S1 in 1990 after a fall. The recovery will be challenging especially if you’re debilitated before hand. You’ll need to see what the doctors suggest and I agree with others in the MILD procedure can fix you by all means do it. My fusion is with stainless steel plates and screws which have their own issues. These days titanium is used instead with great results. Good luck.

@laughlin1947
Where is your pain? Is it your back or your legs and I was wondering where you live and who said they would do that mild procedure? I'm 74 and I was told I'm not a candidate for mild. They said I need something much bigger which I'm extremely husband to do after reading all the complications that can happen. So I'm looking for people in their 70s who are getting minimally invasive surgery and where they're going. Thank you