<s>[INST] According to the an MRI that I had last month, the very last disc is almost poking thru my spine. My Dr. sent me to see a nuerosergeon, who confirmed the problem. It has the sciatic nerve pinched and I am in severe pain 24/7. The surgeon refused to do surgery because I am a smoker. I have had several other kind of surgeries and still smoked and healed up just fine. So what else can be done for me to get rid of all this pain? I hate living on pain pills. [/INST] Hi, As a first line of management you can try analgesics like Acetaminophen or Gabapentin for symptomatic relief. If pain persist despite taking all the analgesics, you can consult a neurologist and get evaluated. Wishing you good health. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain </s>