Try facet injections, then a discogram
I agree that ruling out the facet joints is a good idea, but your level of pain still sounds to me like it could be discogenic (sadly I have a lot of experience with it!). I would have facet injections (nerve blocks as you mentioned), and if the pain is coming from them, that should help. If the pain is not resolved (or at least not fully), I really think the next step is to have a discogram on L3-L4. It could be that your pain is coming from BOTH sources (facet joints and the L3-L4 disc), but the only way to know is to test both---injections in the facets and a discogram on the L3-L4 disc.
You cannot control your pain until you know where it is coming from, and sometimes that can be hard to determine. I recently had a flare-up of my back pain after a long period of doing very well, and we eventually injected the sacroiliac joints. The pain completely went away, and I was shocked! I never would have guessed that the SI joints were the cause of the pain, but it goes to show that you must leave "no stone unturned" in trying to diagnose the source of back pain.
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Charles B. Fainberg
Back pain suddenly started 9/05, no injury or cause
PT, Chiropractic, Epidural Injections - no help
DDD confirmed via discogram at L4/L5 & L5/S1 (with issues at L3/L4 but no concordant pain) 3/06
Failed SED (Laser Endoscopic surgery) 4/06
2 level ADR (L4-L5 & L5-S1) with Maverick disc at Stenum 8/06
XLIF Fusion (L3/L4) 9/08
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