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

### input:
My name is James Im 57 years Retired Diesal mechanic in 2008 I hurt my back I was out of work for 6 mots I went back to and again hurt my back in 2013. my back doctor wants to do a medial branch block . I also have a annular tear L4-5 what is a block ? I.m in so much pain also walking is painful sitting and laying down. 241 lbs

### output:

As per your explanation looks like you have a severe spinal problem. You have told about medial nerve block this is something where your doctor will give steroid injection to particular nerve, which pains you a lot. As per my suggestion this is not going to be a permanent solution. This will give you temporary relief from pain for few months. For proper treatment, I suggest you to go ahead with spinal MRI both for cervical and lumbar and as per the report I suggest you to visit orthopedic doctor. Here if there is a major problem with spine with loss of spinal curve, and disc problem (disc prolapse or disc degeneration) then doctor will suggest you for surgical correction, and later he will ask you to follow up with spinal exercise program. But if there is no much damage in spine then doctor will suggest you for few medications (muscle relaxant, painkiller, vitamin B etc.) and physiotherapy treatment (conservative management). Here physiotherapy treatment will help for relaxing your muscles and soft tissues and so that it will also give you some pain relief along with this when you follow physiotherapy spinal exercise program this will help you to improve strength and stamina of your spine as a whole. You can also use hot pack at home to have some more relaxing effect on your soft tissues. Here you need to understand pain is a symptom and not a cause so if you are treating pain it is going to be a temporary solution so I always suggest all my patients to find out the cause and take proper treatment for it. This helps for permanent relief. Take care.