<s>[INST] I had an MRI lumbar spine due to pain that travels from my back to my right side and down my leg.  The results say I have a large hemangioma of the L4 vertebral body. Small dorsal annular tear in the left paracentral region L1-2. And Schmorl's nodes are present at the endplates of T11-12 and T12-L1 and are chronic in appearance. [/INST] Hello and welcome to ‘Ask A Doctor’ service.  I have reviewed your query and here is my advice. Your symptoms of back pain and radiation to the right leg is suggestive of radicular pain symptom due to pinched nerve or nerve compression at the exit  of your spinal cord.  This is usually seen on MRI spine and I would expect to see on the right side of the Lumbar area L1-S1 (depending on area of distribution of pain). Hemangioma is a collection of the blood vessel in the vertebral bone. This should not cause any pressure on the nerve roots or spinal cord and thus would not cause the symptoms. Hemangioma in vertebral body is a very common finding and it does not have any clinical significance most of the times. Annular tear could cause pressure on the nerve roots but it is the opposite side of your pain, and thus we can ignore that. Schmorl's nodes are clinically non significant findings as well which does not explain the pain. If you were my patient in clinic, I would order EMG/Nerve consuction study to get a neurophysiological data of nerve root involvement. Usually this pain is treated well with pain medications like gabapentin, pregabalin, amitryptilline or duolexetine. Physical therapy and avoiding movements which brings up the pain symptoms is recommended. This usually subsides in few weeks. Hope I have answered your query. Please do not hesitate if you have any more questions. Regards,Dr Shivam Mittal (Neurologist) </s>