<s>[INST] hello doctor morning  i have a pain in lumbago  neuro surgen suggested took mri , shown l4,l5 and s1 pain causes degeneration changes and protruded on to theca . my question is .. is that perminetly replace my lumbar spine with medication or if not  if go to surgery is it perminenty and guarenty. plse anser [/INST] Hello, I have studied your case. Medication like methylcobalamine with muscle relaxant and analgesic will reduce pain; you can take them consulting your treating doctor. You may consult physiotherapist for further guidance. He may start TENS, or ultrasound which is helpful in your case. I will advise checking your it B12 and it D3 level. Medication may give relief for some days, pain may recur on nerve compression. MRI shows disc compressing on nerve root then surgical decompression is permanent solution. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Take care </s>