<s>[INST] Hello Doctor:For L4 and L5 nerve impingement I've received a succession of 5 epidural steroid injections over the past 2 years.The most recent 2 epidurals have been less effective, tha\n previous injections.  I am 78 y.o., 5'9", 125 lbs. andexperience backache and leg pain daily and swim or walk amap.I am interested in alternatives to the spinal injections treatment, but not necessarily surgery.Thank you for your attention, Polly [/INST] Hi, It seems that you have disc prolapse which impinge on L4 and L5 roots which is producing these symptoms There are numerous nonoperative treatment modalities. Most encompass a combination of bed rest, physical therapy, chiropractic care, and medication. Analgesics or muscle relaxants can sometimes help relieve pain. The most commonly prescribed drug therapy involves NSAIDS (non steroidal anti inflammatory drugs). These reduce inflammation that may be the causative factor underlying nerve root pain. Proper exercise can also help prevent back problems and is included in many treatment regimes. A physical therapist or chiropractor can work to create an individualized exercise plan to best suit each patient. You also need to reduce your weight and also use lumbosacral belt and avoid lifting heavy weight.Hope this will help you </s>