"1:1THC to CBD ratio. I have severe L-4, L-5 back pain, and spinal stenosis."
I am not a doctor but in terms of pain relief have you tried a topical? Sweet ReLeaf is a wonderful topical that helps with localized relief. They also have a double strength that can be used on chronic pain, such as yours. I have nerve pain in my back and I have used this product successfully and i have heard from many others, great relief stories.
In my experience, it often takes a lot of experimentation to find the right formula of product, ratios and strain and it is highly dependent on the person and condition. Have you tried vaping? Anecdotally, we seem to hear a lot from people with back pain, who find relief with vaping throughout the day. It is discreet and you could start with a high CBD ratio pen if you do not want to feel stoned/high.
Again, I do not suffer from the kind of pain you have and I am not a doctor, these are merely suggestions. I wish you well.