Lumbar Spinal canal narrowed with facet degeneration

Dear Ask The Doctor: i'm still experiencing l4 l5 lumbar pain and radiating to the buttocks and left leg i want to know what kind of treatment do i need and does a discectomy help lower back pain or do it just help radiating to the buttocks and left leg. ct scan:congenital narrowing of the canal.mild narrowing at l3-4.moderate narrowing at l4-5.small central protrusion at l5-s1. x-ray:bilateral facet degeneration at the l4-l5 mri:l3-l4 posterior disc bulge with superimposed small central disc protrusion. there is no significant spinal canal stenosis.the neural foramina are patent l4-l5 posterior soft tissue post surgical changes.degenerative disc changes with decreased disc height and t2 signal intensity. a small midline protrusion with inferior annular high signal area either from postoperative change or annular fissure mild disc desiccation and facet degeneration bilaterally. mild associated canal stenosis. no significant foraminal stenosis. l5-s1 minimal diffuse bulge without significant canal or foraminal stenosis.

Dear Lawrence: Degenerative disc disease produces changes in the vertebrae including the facets, that along with the bulging disc are causing a nerve compression which is the cause of the pain. The treatment options depend on the age, severity of the pain, neurologic symptoms present and if you have some other associated health issue. The first approach is conservative as a Physical Therapy program aimed to control pain and inflammation along with anti-inflammatory medication, if there is no improvement and with time the pain is worse and intractable you should get a reevaluation by an orthopedic surgeon to decide if Surgery might be consider as a treatment option for you.