I am a 49 year old male who 4 years ago had a discectomy and laminectomy to address a 10 mm herniated disk at L5-s1 level. Now I am back to having significant sciatica symptoms in the left buttock and left leg, same side as prior surgery, making everything I do accompanied with significant pain.. A recent MRI indicates no significant herniation at this level, only 2 mm bulge in the annulus and minor spondylosis with minimal proximal right L5 foraminal stenosis. L4/L5 level is similar to pre-surgery 4 years ago with a 3 mm left lateral protrusion with minimal extrusion through a tear in the annulus fibers contributing to moderate proximal left L5 lateral recess without foraminal stenosis. There is only minimal scar tissue surrounding the left S1 root sleeve. I now have continuous twitching in my left calf muscle and I am in significant pain and have trouble walking more than 1/4 mile where previously I was running 10 miles a week and very fit. Dr is recommending epidural and possible pain meds such as antidepressants to block the pain signals before considering surgery again. Do you think that epidural fibrosis (scarring from the initial surgery from 4 years ago) could be the problem and if so why did it take so long? Any other thoughts on this situation is greatly appreciated.