What treatment bulge l4l5 l5s1 close to s1 nerve root for 2 years now severe disabling pain just in bed epidural pt nerve block scs trial nothing help?

Pain L5-S1: Probably will have to see a neurosurgeon for back surgery. The choice should come after you understood clearly the risks vs benefits of the surgery, and possible complications. It is not a simple pathway but it has to be taken after you exhausted all other methods of treatment such as pain procedures, physiotherapy, physical therapy, etc. A good approach will be minimally invasive surgery.

Neuromuscular: The treatment includes physical therapy with traction and lumbar stretching exercises, muscle relaxer, analgesics, medications like Neurontin Lyrica (pregabalin) Cymbalta or amitriptyline. Pain clinic and acupuncture are last resort prior to consideration for surgical intervention. I would consider repeating the MRI if not recently done, and get neurological or pm&r evaluation for emg. Check for fibromyalgia.