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

### input:
in august I was stopped at the rotary and another care hit me from behind. I felt a pain to left of l4 l5 and it shot to straight across to left of my lower back and stopped. it felt like an electrical shock. two days later when I sat down the pain was horrible. I was diagnosed with lumbago and a S1 ligament/joint strain. my mri revealed an asymmetric disc bulge to left at L4-L5 which contacts descending left L5 nerve root in the lateral recess and also results in mid left foraminal narrowing at this level. I have a had two epidurals and one trigger point injection. trigger point injection had kenalog, which hurt like a bee sting and continued to hurt for weeks. this area sometimes still feels like a bee sting. now my back doctor wants to give me facet injections at L4 to S1. pain is really bad to left of L5-S1. pain radiates down to tailbone and both sides of sacrum can hurt. sitting and bending backwards can really hurt. the area can feel like a rug burn. pain from bulging disc no longer goes down left leg. Also I no longer have pain to left of L4, but my doctor wants to put a facet injection in this area. I a very fearful of these injections. I also have mild diffuse degenerative disc disease thoughout the lumbar spine without central canal stenosis and facet arthropathy at L5-S1 resulting in mild bony foraminal narrowing. my back doctor thinks MVA jumpstarted facet pain. could pain be caused by facets?

### output:

Hello There ! It's good that there is no radiating pain from the disc bulge. Facet pain could be one factor, however there could be pain originating from other aspects too in your case like ligaments, due to the MVA. If there are no motor and sensory defects, like muscle weakness, numbness or sensory loss, my suggestion would be to give a try to conservative pain management remedies. A PHYSIOTHERAPIST has a host of tools to manage your pain and can also assess where it comes from. Kinesiotaping, Ultrasound, TENS etc. and gentle manual therapy as indicated can be applied with excellent results for pain in low back and sacral areas. Be aware of your postural habits though, some lifestyle changes could be suggested by your physio to help you correct your body mechanics and manage pain better. Tc