### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I have had two prior surgeries. the first in august 2009 and the second in march 2011. Li and l-2 in 2009 and l-3, l-4 amd l-5 in 2011. Back never recovered after 2nd surgery. As I stand up my back loclks up and feels like bone on bone scraping. The pain is intense and makes it hard too breathe. Both SI joint areas hurt as it alternates from one side to the other with the right side being the constant area where I get hip flare ups, pain down leg and down to my big toe. I have had multiple MRI s and at one toime in 2014 was told by surgeon I needed surgery as the disk was chipping on opposite side of where he had performed prior surgery. He decided as I waired for wifes insurance to kick in and he changed his mind. I went to new surgeon in the same office and he saw nothing on the same MRI that showed a problem in 2014 and didn t think the current MRI warranted surgery. The pain is incredible about 5-7 months out of the year and not so bad the rest of the time though I am on opiates for pain and they help keep the pain to a dull roar during the better months. Nothing helps much when I have the stabbng sensations like I am feeling at the present time. There seems to be no particular thing that sets it off. I had been seeing a pain dr up until the first surgery and even for 2 years after the second surgery. Trigger point shots stopped helping at all. Is there any type of surgery, such as cageing mt lower vertabre, which would help or will this continue to get worse as time goes by? Setting upright seems to put a lot of pressure on lower back and exacerbates the problem.

### output:

Hello! Welcome to Chat Doctor!  I have studied your case. You may need to do MRI spine again with contrast to see for nerve compression. If your new MRI shows disc bulge with nerve compression then surgery may help. Due to compression of this nerve root there is tingling numbness in your leg and pain associated with it. For these symptoms analgesic and neurotrophic medication can be started. Till time, avoid lifting weights, sit with support to back. You can consult physiotherapist for help. Physiotherapy like ultrasound and TENS therapy will help. Yes your symptoms may increase with age and instability with associated nerve compression.  Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.  Take care 