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

### input:
My wife, 62, recently had been in a car accident. MRI showed: 1) levoscoliosis in the cervical spine . 2) Grade 1 levoscoliosos of C5-C6 3) L4-5: 2-3mm diffuse posterior disc bulge with bilateral paracentral annular tear causing narrowing of the anterior thecal sac and right foramen. There is another tear in the areas of L2-3, L3-4. L5-S1 disc dessication. 2 mm diffuse posterior disc bulge containing a 1mm midsagittal annular tear. What treatment would you recommend?

### output:

HiT hank you for your question to Chat Doctor. Scoliosis of the cervical spine was certainly pre-existent and not caused by recent car accident. The treatment for annular tears causing back pain is1 Anti-inflammatory medications like ibuprofen, meloxicam or naproxen2 Analgesics like tramadol and sometimes even stronger ones like oxycodone under the supervision of a doctor3 Physical therapy once the acute pain is resolvedYour wives treatment will depend on symptoms. Treatment for pure back pain would be as described above. In the presence of radiating leg pain if it is right sided L4-5 foramen narrowing on right side may be the cause. In that scenario after trying above-mentioned medications and physical therapy, epidural injections can be done by a spine surgeon or pain specialist. These are mostly helpful and can be repeated if necessary. If the injections cease to help a discussion with spine surgeon about surgical decompression is recommended. Hope this is helpful. I would be happy to answer any questions you may have.