Hi, Thaks for writing in. 1- Diffuse posterior protrusion with posterocentral inferior migration of L4-L5 intervertebral disc with mild thickening of ligamentum flavum at L4-L5 intervertebral level compressing thecal sac and traversing nerve roots, compromising the spinal canal and encroaching bilateral L4-L5 intervertebral neural foramina. This shows that there is significant pressure on nerve roots due to t he disc protrusion at L 4 - L 5 level. This is causing pain in the exiting nerves with possible encroachment of spinal canal posteriorly. 2- Posterocentral small anular tear in L5-S1 intervertebral disc. This is a small tear in the L 5 - S 1 disc and also may cause mild pain. 3- Diffuse annular bulge of L5-S1 and L3-L4 intervetebral disc.. The discs at L 5 - S 1 and L 3 - L 4 also show mild bulges. 4- Posterior bulge of L2-L3 intervertebral disc. The disc at L 2 -3 L 3 also show mild bulge. Medications are always the first line of treatment. Specific neurogenic pain relief medications are available. These must be given for weeks to months. Physical activities also must be limited. If there is increase in severity of pain even with months of medication then surgery may help. Laser assisted surgery is done in some hospitals which has a good cure rate.