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

### input:
Hi Doctor, I did my MRI couple of days ago. I am 6 2 , 330lbs, living sedentary life style. I am having pains in my lower back and mostly in my ankles, both left and right in the peroneal tendon regions. Barely some numbness in the left hand at times, at times pain in hips and buttocks region. The reading is as follows: -L4-L5: There is evidence of a small left foraminal and extraforaminal disc protrusion which produces mild narrowing of the left lateral neural foramina and produce slight displacement of the left exiting nerve root. Very mild facet arthropathy is present. L5-L1: There is mild diffuse disc bulging asymmetric to the left without evidence of disc protrusion or central canal stenosis. There is mild face arthropathy. Conclusion: Small left foraminal and extraforaminal disc protrusion at the level of L4-L5.

### output:

Hi, thank-you for providing the brief description of your history and MRI scan report. A thorough neuromuscular assessment is advised. As due to the disc protrusion the tissues of the disc are touching the existing nerve roots due to which the pain is persistent in your calf region. I will advise you to undergo physical therapy as it will help to reduce the inflammation and pain by Therapeutic ultrasound therapy and TENS therapy. Later on, executing the exercises will help further to strengthen the muscles of the core, pelvic floor, spine, lower limbs. Post stretching the compression on the nerve root will be relieved, and the pain symptoms will come down. Following the exercises on a later stage will help to maintain the spine stability. In my Clinical practice I see cases with similar issues, and they respond 99% well to physical therapy even in long term run. RegardsJay In Chat Doctor. 