Hi, thanks for writing to HCM. This is just to let you know that xrays will only provide information on the bony elements of the vertebral column. An MRI scan is mandatory in all cases of Chronic Low back pain cases to rule out any issues in the spinal cord, intervertebral disc and the spinal nerves. Generally, conservative management (non surgical means) is the initial choice all cases of Low back pain, which includes the following - - Usually 1-2 days of bed rest will calm severe back pain. Do not stay off your feet for longer, though. - Maintain optimum body weight,if you are obese - Avoid lifting heavy weights as it imparts more strain on your back - Change your daily activities so that you avoid movements that can cause further pain, especially bending forward and lifting as it will worsen the disc protrusion. if you want to bend forwards, do it with your hips and knees flexed. - Use a lumbosacral back support to stabilize your spinal muscles - Intermittent pelvic traction might be helpful to cause a regression of the protruded disc - After the initial pain has subsided, remedial exercises to strengthen the spine are very important to restore normal spinal movements and muscle strength. The main aim of exercise is to encourage mobility, reduce muscle spasm, prevent further deterioration in the muscles and speed recovery. - Use analgesics like advil or aleve and muscle relaxants to relieve pain and muscle spasm, as needed. Vitamin B12 supplements & Pregabalin may be helpful in controlling the neuropathic pain. If your symptoms are not improving with the above measures, consult an orthopedic surgeon for further evaluation and management. Hope this information is helpful. Good day