Suggest Treatment For Lower Back Pain With Disc Bulging

Hi - I am 40 and have been experiencing lower back pain for I think 7 yrs. I have an old MRI from 06 saying sml annular tear assoc with disc. No frank spinal stenosis. Sml Disc bulge at L5-S1. I was on my knees Sat could hardly walk w/o screamin for 2 days. Emerg rm gave me 3 differ pain pills that have been just makin me throw up. I have done phys therapy yrs back and every year it seems to be worse. Any suggestions? Surgery?