Ok ~

At L4-5, besides the broad based disc bulge, there's an annular tear. The annula is a sac that the disc sits in, and when it tears it releases fluid that kind of "burns" from what I understand. Plus the bulge is abutting the L-5 nerve root, which is gonna hurt.

L5-S1 There's a disc extrusion (herniation) of 8mm (big) resulting in compression of the S1 nerve root (OUCH)

Remember, I'M NO DOCTOR -- but from this, if I were a doctor I wouldn't do surgery. Instead, I'd send you to physical therapy, or a pain management doctor. Surgery would just cause you MORE trouble. Pain management would give you more options for pain relief.

Even tho it's a large herniation, he only has intermittent leg pain. At this point therapy would be the best option. Having surgery would honestly cause him more problems than he has now -- no kidding! He would regret it later on. But he's the one who has to make the decision. I would HOPE that he would get other opinions besides your cousin.

God bless and please take care. Hugs, Lee