When the ESI injections do not work the first time, most doctors want to keep at it. Very expensive to insurance and out of pocket, a real money maker. Also the risk with them is there. I am not a big fan of them Artic. My own experience with them wasn't so good. I am fused C3-7.
Between my fusions, I had something called a Ketamine infusion. This is done with a pain specialist however. They use a floroscopy and a thin cath into the places that are damaged. There was no pain at all for me, before, during or after, and it provided about 4 months of relatively pain free existance. I had several of them. The final one didn't work, and it was at that point, my pain specialist after viewing on the floroscope just what my cervical spine was doing, said I should go to to a neurologist again. These shots, any of them, (facet blocks as well) are a temporary fix Artic. They are all worth a try to stay out of the operative theater. That really is a last resort.(surgery)
I didn't have to sign a pain contract with my physiatrist at all. She really did get me on a better track after my fusion. I still get help when needed with medications. Tramadol didn't do squat for me either.
I sure hope you can find some resolution. I really believe if you find a pain specialist, it would help you. They are not all jerks. I interviewed 4 of them before finding my current doctor. It was worth the effort to do this.
I hope you have a good weekend. I am here anytime to talk to. ginnie