Thank you for posting your query.
It is unfortunate that his pain has not completely settled even after about six months of rest and physiotherapy
pain is unlikely to persist for this long. Also, L4-5 disc degeneration pain should get better with physiotherapy.
So, I would suggest further evaluation with bone scan and may be a local epidural injection for pain relief.
Please get back if you require any additional information.
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)
Senior Consultant Neurologist
Apollo Hospitals, Hyderabad,
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