[annapurna]

c4c7,
As you mentioned, everyone experiences pain differently. It's also true that it's very hard to correlate the results of an MRI to the pain level that a patient experiences.

I can't say when you should get surgery but I'd suggest taking a very hard look at your life. When you're sustaining your pain-free episodes by deleting activities that you really want or finding that you're dropping out of stuff that's important to you because you can't be sure that you can do it without pain or be sufficiently pain-free to participate, it's probably time to find a surgeon and get serious about moving forward. With an episodic pain like you describe, it'll likely be quality of life that drives you to making a decision rather than just rating the pain level you have.

Laura's L5S1 Charite decision was like this: Prior to surgery she had mostly pain-free days with painful flare-ups. The decision was pretty clear when her flare-ups started interfering with driving home from work; 1/2 hour in the car was enough to trigger a flare-up and, even then, I ended up having to push her a bit to recognize how much of her life was on hold due to the pain.

To balance the advice you've gotten about putting this off: when you're sure that your situation is definitively going downhill, it might be smarter to talk with a surgeon then and not put off the discussion. While the technology is getting better, delaying can lead to damage to your spine that will eventually limit what can be done to repair it. If you delay indefinitely, you'll eventually reach the point where fusion, or even autofusion, is the only option available due to the extent of damaged structures. It doesn't mean that you have to immediately go from that talk to a surgery date but it's smart to understand where you stand once it's clear that surgical intervention will be needed at some point.