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

### input:
Dear Doctor, I am resident of Delhi NCR. During the changes in seasons: I get severe pain in my both legs - Both legs becomes lethargic, despite of wearing winter dress fully. Thorough check by doctors is over and confirmed that it is due to a pressing nerve at Lumber 4. Why it happens? How to eradicate this problem -No medicine found - Doctors gave injections to increase energy in legs. Improving sitting posture . Even if I apply pressure for passing stools , my L4 pain aggravates. I am allergic to all kinds of pollutions - Vehicular pollution, smoking pollutioin, Fog in winters, etc. - I get sneezing and cough severely - Using HomeopatChatDoctoredicine. I am patient of Hyper Tension - Using (a) Nebicard-H (b) Telma 40 and (c) Clopivas 75mg everyday. Kindly suggest permanent cure for all these ailments. Thank you, T. Chandra Sekhar, Age 47 Email: YYYY@YYYY Mobile: +91 98 181 0000

### output:

Hi Mr Chan Chat Doctor. Feeling of pain, heaviness/fatigue in legs is caused by stenosis or narrowing of the central canal in the spine where the nerves are pinched. L5, S1 and L4 are the common ones to get compressed. The cause of this is degeneration of the spine which means age related arthritic changes in the spine. The intervertebral disc bulges, bone spurs from the vertebrae (osteophytes) and a thickened ligament between vertebral bones contribute to this stenosis. Initial line of treatment for this is pain relieving medications, brace and physiotherapy. Epidural injections are done in spine around the affected nerves and reliably offer pain relief. All these treatment options relieve pain but unfortunately none of these can sure the basic pathology causing this pain for which surgery is necessary. Hope this is helpful. I would be happy to answer any questions you may have.