<s>[INST] I have a mild broad based disc bulge with an annular tear at L4-L5 with mild crowding of the exiting nerve roots.  I also have transitional segment with partial sacralization of L5.  I also have a benign hemangioma present at L4.  I have been to a chiropractor, have had 3 coritizone shots and have done physical therapy for a year now, but I have not noticed much improvement in the pain as I feel it everyday.  It radiates from my lower back down my right leg.  I do stretching exercises and use the elliptical.  I am looking for advice as to what you would recommend that I do at this point.  Any advice would be grately appreciated.  Thanks. [/INST] Hello I have gone through history provided by you. No treatment is indicated for benign hematoma. For annular tear and disc bulge you definitely need treatment. Because of annular tear and compression of nerve roots you are likely to have persistent pain. My advice would be (i) Have an examination by neurologist to assess for any deficit(ii) To continue physiotherapy under guidance of a physiotherapist, (iii) Have simple analgesics under care of your doctor. Personally I do not favor corticosteroids except for local injection.(iv) If above fails, surgery can be considered. Regards Protein </s>