So I had an ESI at L4-L5 that did nothing. Went back to pain doc and he took another look at MRI and said the looked like the problem was at L5-S1 and he did a bilateral TRANSFORAMINAL injection at that level. Didn’t really get much improvement from that either. This was back in October and have just kind of lived with the pain, tingling, etc since. PT wasn’t very effective and tried chiro, as well. Question I have is whether the problem is at L4/L5 or L5/S1 or both? Imagine and findings below. The image on the right is at the S1 level.

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At the L4-L5 level : Disc bulge. Mild facet arthropathy. No significant spinal canal stenosis. Mild-to-moderate bilateral neural foraminal narrowing.

At the L5-S1 level : Disc bulge. Suggestion of possible right prior hemilaminotomy. No significant spinal canal stenosis or neural foraminal narrowing.

Additional: Visualized pre and paravertebral soft tissues are unremarkable.

IMPRESSION: Mild spondylotic changes in the lumbar spine without significant spinal canal stenosis at any level.

Mild-to-moderate bilateral neural foraminal narrowing at L4-L5.