Capper,
It would seem that your pain generating issue is at L5-S1 where you have a herniation aka protrusion. I am not an MD, but a personal injury attorney, and I have read a lot of MRIs in my day. The MRI you posted is missing stuff, specifically it doesn't say what the MRI 2 years ago showed at the L3-4 and L5-S1 levels and it also doesn't provide a comparison in terms of the advancement or lack of advancement of whatever condition was identified at those 2 levels 2 years ago. It looks like someone forgot to finish the first sentence and perhaps the comparison section was left out.
The L5-S1 disc level being the pain generating source is consistent with your complaints and articulations of your pain issues.
Talk to a neurosurgeon specifically about medial branch blocks (MBB) and radio frequency ablations (RFAs) which are procedures used to treat and inform further on these kinds of disc issues. The MBBs are diagnostic and will confirm the pain generating source and the RFA could provide relief. Read up on these procedures and disc with a neurosurgeon and/or an associated pain management specialist working with the neurosurgeon. Don't accept the pain you are in. Good luck and happy holidays.