<s>[INST] I have a bulging disc at L4L5 with degenerative disc disease and severe rheumatoid. Tonight I cannot lay down or sit. I can't stand up straight. The pain shooting down my back in taking my breath away. I also have developed a headache. I have tried heat and cold packs. I also took Nucynta around 2 hours ago & it's doing nothing. I am in major pain. Should I go to ER? [/INST] Hello. Thanks for writing to us. You need systemic muscle relaxants like chlorzoxazone or thiocolchicoside to relieve yourself from this pain. You can attend an ER for a short term relief. Lumbar traction can help in relieving the acute pain. I hope this information has been both informative and helpful for you. Regards, Dr. Praveen Tayal drtayal72@gmail.com </s>