LadyLaura - I had the 3rd shot in August. I could have had the 4th shot earlier this month but I'm waiting to see if my doctor is successful getting the insurance company to cover the shot. Due to pain levels, I am regretting the decision to postpone the shot. Long-term treatment - I'm beginning to consider surgery. My other side was operated on about 8 years ago and is so far doing great but I'm still hesitant to go the surgery route.