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

### input:
I am 70 years old and have been in good health. High blood pressure, but under control with meds. I have been diagnosed with spinal stenosis. MRI has indicated mild dextroscoliosis and Moderate L-34 and L4-5 desiccation with facet joint. Physical therapy did little and shots in the spine did not help. I was close to considering surgery (my dr. did not encourage it, but said I knew my own pain level), but then my pain eased up and I have lived with little pain since. Mornings have been the hardest, but usually when I am up about half an hour, I feel better. Some days are rough. Today, however, I woke up okay and then had a gripping pain to the right side of my spine (looking at the back) and cannot walk upright. I have a walking stick and walk like Yoda. This happened about 3 weeks ago, but the back eased up after an hour or so. My question: Do I need to go to the emergency room? Am I in danger of paralysis? My legs are not affected. I can lift them even when I am in pain and laying flat.

### output:

Hi sir/mam, your MRI suggests lumbar disc degenerative disease. Usually flaring of pain and subsiding occurs on and off as a natural course of the disease.no need to rush to any emergency. Just take the following precautions even when pain is reduced.  1)take care of your posture. Prevent abnormal postures.  2)avoid prolonged standing and sitting and strenuous exercises.  3)take the instructions of your physical therapist regarding stretching exercises to strengthen back muscles.  4)avoid lifting heavy weights. When pain is severe, you can go for analgesics. But avoid NSAIDs.tramadol with paracetamol is well tolerated in old age. Physiotherapy techniques of ultrasound and electron therapy also would help. Until you are able to walk and move your legs and sensations are intact, no emergency or surgical care is advised. Hope my answer allays your anxiety. Any further questions are always attended promptly. Wish you a very happy, healthy and peaceful new year. Thank you. Take care.bye.