Hi Glenn,

IMO (and those of many others here) surgery should only be considered as a last resort after exhausting all other treatment options, and at least a second opinion (or more). Pain management has a lot to offer besides epidurals and physical therapy (PT), though they often try those first. There is also some sage wisdom on this group that while surgery can repair mechanical problems, it often cannot fix pain.

The efficacy of PT can depend on the therapist; like doctors, their knowledge and experience can vary greatly, so I wouldn't rule out another go at it with a different therapist. Calling around and asking (like you would about finding a doctor) might help locate a better one. I went to several before finding the right one for me, and that therapist helped more than all the others combined.

If your current medication regimen isn't working, a change may be in order, depending in part on the nature of the pain. I read your comment about losing faith in doctors; I get it - many of us have been there when there aren't any good answers and we're in pain. If the ortho can't help, ask about pain management. They can do something about that.

Google: talk doctor pain

I'd also encourage you to peruse the chronic pain forum:
http://neurotalk.psychcentral.com/forum10.html

http://www.foresttennant.com/

http://www.practicalpainmanagement.com/

Doc