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

### input:
Im a 43 year old hairstylist, Ive had major chronic back pain for over 6 months now, my MRI report states  at L-5 si there is moderate degenerative disk space loss and mild generalized disk osteophyte complex in mild central canal stenosis and moderate neural foraminal stenosis is present bilaterally and minimal bilateral facet arthropathy,, Ive been a ton of times to the chiropractor,  which made it a little better , but not a whole lot. Where do I go from here,, pain management center , spine center? Ive tried yoga , core strengthing , have always been fit and active but working out seemed to make it worse, I try and stretch, because back muscles feel soo tight and hip flexor muscles are very tight as well but  nothing seems to take pain away,  I   Sitting hurts, laying down hurts and a long day at the salon on my feet def, causes a great deal of pain

### output:

Hi, thanks for writing to Chat Doctor. All the MRI findings in your description suggests a degenerated lumbar spine (wear & tear changes). The initial management of this condition is always by conservative means (non-surgical methods) which includes different modalities like Physiotherapy, Spinal manipulation, Ultrasound therapy, Epidural spinal injections, TENS etc. All these methods have to be followed for at least 6 weeks period to have a symptom relief. As you have tried all varieties of treatment but without much improvement in your condition, I suggest you to try RADIO FREQUENCY ABLATION, which may help you. Radiofrequency ablation (or RFA) is a procedure used to reduce pain. RFA can be used to help patients with chronic (long-lasting) low-back and neck pain and pain related to the degeneration of joints from arthritis. The degree of pain relief varies, depending on the cause and location of the pain. Pain relief from RFA can last from six to 12 months and in some cases, relief can last for years. More than 70% of patients treated with RFA experience pain relief.  Hope this information is helpful. Good day