Agree, just because you can do peripheral nerve blocks for anesthesia purposes and blind lumbar/thoracic interlaminar epidurals, that doesn't mean you can or should practice pain without a fellowship. Those procedures I just listed only constitute 1% of a typical pain practice.
You need a fellowship to properly practice pain, so you treat people appropriately and safely. The best way to do this via an ACGME pain fellowship, but if you're set on pursing spine/pain, there are many good non-accredited fellowships out there, as well as a few sweatshops, so check them out and talk to people who graduated recently from programs that interest you.
In the good non-accredited spine/pain fellowships you may get as good or better procedural experience than the bottom half of ACGME pain fellowships, particularly with high-level procedures such as kyphoplasty or spinal cord stimulator permanent placements. The main clinical issue with non-accredited fellowships is that you'll have a less rich educational experience on pathophysiology, pharmacology, psychological disorders, etc. Most of that can still be learned if you're motivated and do outside learning.
From a practice standpoint, there are many physicians with thriving practices who did non-accredited fellowships. You can practice in most of the country without an issue, and if you stay in Texas, you'll be fine in 95% of practice situations. But you will run into problems if you eventually want to practice in an highly desirable location like LA or Manhattan, as hospitals and insurance companies in these areas may not accredit/pay you.