You note: “My medical team is suggesting epidural injections as an aggressive step if i want to go there, though i am not sure that will address radicular pain only the low back pain from the arthritis. For your stage in this HNP/spur nerve compression, injections are a good choice. The injections are actually more effective for nerve root pain than lower back pain.
Your herniation: “moderate size broad-based/central extruded disc with slight inferior migration and slight posterior deviation of the proximal S1 nerve root bilaterally” is not huge but is not unsubstantial. If the injections don’t control the pain, a microdiscectomy is not a big surgery and has good results in the right hands.
Dr. Corenamn