I have/had three in my sacral region and, after 9 years of symptoms, ended up having surgery with Dr. Feigenbaum in Texas 16 months ago. I also had a consult with Dr. Welch in Philly. There is a third expert in Sacramento, CA - Dr. Schrot. Having a consult with one or more of the experts is very helpful in understanding what is going on in your body. It is possible that epidural steroid injections can make the condition worse or may even be causal so it may be best to avoid this intervention which is often suggested by doctors who are not knowledgeable about the condition. There are some good scientific articles about Symptomatic Tarlov Cysts. I will find a few and post here. They can be helpful with your doctor. Good pain management is key and believing in yourself - you know your body best!