Mri states severe bilateral neural foraminal encroachment with L4 and L5 nerve root compression. Have had esi no help severe pain gait and motoring issues. Spinal surgeon says see neurologist what sho?

Good First Step. As an anesthesiologist and internist, i completely agree with your surgeon. The first step is to evaluate your candidacy for either pt or transforaminal (ct- guided) injection before going to the slightly more invasive percutaneous, or open surgical, discectomy. It's wise to approach your condition "conservatively, " unless severe pain or loss of nerve function require more rapid action. No worries.
EMG. Look for another source of your pain if esi didnt affect your pain at all then image annormality unlikely scource need objective confirmation of theory that image abnormality is causing your pain if you are weak some where . Emg can provide this confirmation confirm which nerve root or nerve is causing weakness not as good a test for pain or numbness see the neurologist for the emg.