It has been nearly two years since I had back surgery to fuse L4-S1. Now there is degeneration at L3-L4 and it has been found to be a positive pain generator and there is talk of fusion there because the epidurals last only about 1 week. However those epidurals only work on the pain that is up higher and the pain that is my very low back in and near the central spine area and extending into my buttocks, hip and sometimes thigh (mostly on the left side but occasionally flaring in the right) is constant and terrible. Certain activities make it unbearable but even at best is a 2-3 on the pain scale. My physical therapist well over a year ago said that there certainly was some scar tissue adhereing to the sciatic nerve because certain movements caused immediate, sharp and severe pain. One of those movements would be when he would try to manipulate my foot and straighten it while my leg was extended. Even extending the leg fully was painful, but when trying to dorsiflex the foot to stretch the achilles tendon I had extreme pain in my back, buttock etc. Now, all this time later with pain still a daily issue I am being treated still by pain management, still on duragesic, etc and have see a doctor about a pain pump (intrathecal fentanyl or morphine) who feels I would be a candidate. My question is this: how can the scar tissue issue be diagnosed and examined further? Is there imaging that would show it more clearly? Is there any procedure that would help to break the scar tissue away? An anesthesiologist doing a myelogram mentioned that I had a huge amount of scar tissue that gave her trouble getting a needle in place to inject dye. I am wondering if this chronic pain may be largely due to scar tissue that is entrapping or irritating nerves and nerve roots and if there is anything pro-active that could be done to address the causative issue instead of treating the resulting pain forever.