What do i do if epidural did not work for lower back pain ?

Image guidance: Epidurals don't always work, especially if you only have back pain and no leg pain. They are more likely to work when they are done with image guidance (fluoroscopy) and sometimes they have to be repeated. You may also need physical therapy and nsaids (or other pain relievers). Talk to the doctor who did your epidural.

ESI: If your esi does not help your pain physician, depending on diagnoses, will refer you for neurosurgical consultation or offer combination of pain medications and physical therapy.

Repeat it: If you have repeated it and it still has not worked, i wouldn't do it a third time. The real place to start is the diagnosis. The cause of your pain deteremines the best treatment. With the diagnosis you can google the best treatment options.