<s>[INST] I have been diagnosed with neuropathy in my left leg. I m wondering if it is being caused by a lower back issue. My MRI said L4-L5 midline protrusion with midline annular fissure. Mild stenosis impinge on the ventral thecal sac. Mild facet arthrosis and ligamentum flavum hypertrophy with patent L4 neural foramen. Also, L5-S1 small left paracentral protrusion with left posterolateral annular fissure,mild mass effect on the arthrosis and ligamentum flavum hypertrophy with patent L5 neural foramen. MRI lumbar spine demonstrates mild central stenosis at L$-L5 due to a central protrusion with midline annular and mild facet arthrosis. L%-S1 small left paracentral protrusion with left posterolateral annular fissure. There is mild mass effect on the left S1 nerve root. Can you explain what this means and is it the cause of my pain? [/INST] Hi, The MRI findings you have described certainly do explain your symptoms of the pain. Between every two vertebrae there is a shock-absorbing material known as an intervertebral disc. It has an outer rim called Annular fibrosis and an inner material called Nucleus pulposus; which is basically the shock-absorbent. Under some circumstances the outer rim can break open (fissure), and the disc then bulges out. Unfortunately as it protrudes out it can impinge or press upon the nerves that come out of the spinal cord to supply your lower limbs. This impingement at various levels, causes the neuropathic symptoms that you are experiencing. This is a very brief explanation and there are many descriptors used which need not be elucidated here. Suffice it to say that this is causing the pain. As for suggesting treatment, I would need to do a full neurological workup and then start you on pain medications like Neurontin for a while and evaluate your response to that. You must discuss this with your physician and then follow up with him. If the pain gets too severe, you could try physical therapies like Inferential therapy which will give you a temporary pain relief while you wait for the pain medications to have their effect. Hope this has answered your question. </s>