Yah, I have to agree with Lizzy also. ESIs are done at different intervals for varying reasons, and is not necessarily a stepping stone toward surgery being the next resort. I have personally had them done to ease my pain while I was in PT because I got flared up and it helped to calm things down a tad. I had them done initally to see if it would help ease my pain and control inflammation. Now it is thought to do more if I want them done, but it would be more of first trying them in certain places to sleuth out or eliminate pain generators.
It's really hard for us to really tell you what's next. I saw over 4 surgeons from the time i injured my spine until the fusion surgery. ALL of them wanted to start fresh as a new patient and run me thru the traditional stuff of medications, PT, injections, then gave up and said.. try more PT and more meRAB, etc. Only the last surgeon I saw was willing to test things further to try and find the source of my pain. Which was the discogram that found the bad disc that looked normal on my MRIs.
So it could be anything, including your doctor saying the word "surgery".
Im sorry you arent any better. Which disc is it and how long has this been going on. When was your last MRI? Were the injections done with fluroscopy?