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

### input:
Hi dr. My mother is facing back pain and after conducting MRI scanning dr. has said that there is a nerve compression in L4 and L5, hence they are suggesting a operation. what can be done as an alternate to operation. Thank You

### output:

The first step in the treatment of low back pain is to rest the spine. Because most cases of back pain are due to muscle strain, it is important to avoid further irritation to the spine and the muscles that surround the spinal column. Applications of heat packs help ease much of the discomfort associated with muscle spasm causing low back pain. Strengthening of back muscles is probably the most important step in treatment of most causes of back pain. Epidural steroid injections are an option for back pain treatment and inflammation around the spinal nerves. Spinal surgery is done when extensive efforts at conservative back pain treatment fails to relieve symptoms.  The surgery of herniated disc is called Microdiscectomy or microdecompression spinal surgery. In carrying out the surgery, the small portion of the cartilage or the bone is removed under the nerve root. This reliefs the neural impingement and more room for the nerve is thus provided. The nerve not only gets free from the thrust but also gets space for healing soon. Another form of surgery for herniated disk is called Percutaneous Microdecompression or Endoscopic Discectomy. In this form of surgery, lasers are used for shrinking the herniated disc. This is the most advanced form of spinal surgery that treats the patient without any cut or tear. There is enough evidence from clinical trials and data available from the past operations that surgery has proved ineffective in many cases. It is a proven fact that only one out of every 100 back pain cases is fit for surgery. The most startling revelation is that 67 % of low back pain surgeries became worse after surgery and 2/3 patients complained of more pain after the surgery. Also understand that back pain is often not a quick or easy fix. A dedicated approach to physical therapy and exercises will often alleviate back pain.