How long have you been seeing this particular pain management doctor?
Insurance companies typically dictate protocols, meaning steps/treatments that must be done before the next treatment option is used.
The fractures should be healed if they occurred several years ago. When is the last time xray, MRI or CT scans were done to check their status?
I am a bit confused why occipital nerve blocks would be done for thoracic fractures? Or botox for that matter? Those are usually related to migraine/chronic headaches/TMJ.
Muscle relaxants are used to treat muscle spasms/tenderness, not typically pain, unless its directly related to ongoing muscle spasms.
As far as going to a new doctor, you always have that option, but be aware that many pain management doctors are shying away from ongoing opiate use, and you may find that the new PM may want to retry things previously done. In fact, that's typically the case.
I'm going tbru the exact thing. Ive begged to let me go to the ER for a morphine shot just to have a break. It's been 8 months. I'm going to check into someone else. Something is very wrong a d I'm sick if being bed bound