Hello @bunting, Welcome to Connect. I think it is really good that you are being proactive and looking for options to help with your pain and you have a Pain Management doctor working with you trying to help. I hope you are able to provide an update after you see the neurologist in San Antonio. From your post it sounds similar to the pain from sciatica which is described in an article here --- All About the L4-L5 Spinal Segment: https://www.spine-health.com/conditions/spine-anatomy/all-about-l4-l5-spinal-segment

I think you might find the following discussions helpful also:
-- Sciatica: https://connect.mayoclinic.org/discussion/sciatica-3/
-- Sciatic nerve pain: https://connect.mayoclinic.org/discussion/sciatic-nerve-pain/
-- Sciatica pain: https://connect.mayoclinic.org/discussion/sciatica-pain/
-- Myofascial Release Therapy (MFR) for treating compression and pain: https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

Can you let us know how your appointment goes with the neurologist?