Can any online doctor help me with the following results?
Patient: The MRI report of my lumbar spine has this conclusion, please explain where to from here?rineural fat signal is preserved. IMPRESSION: Multi factorial central spinal stenosis at L4/5 with associated bilateral lateral recess stenosis. Focal central and marginally left paracentral disc protrusion at L5/S1 resulting in minimal narrowing at left lateral recess but no nerve root displacement or entrapment. Considerable facet degenerative hypertrophy at the L4/5 and L5/S1 levels. Doctor: Hi,  Your MRI report is indicating that you have some common radiographic signs of what we would generically refer to as degenerative disc disease or degenerative arthritic changes likely as a result of OSTEOARTHRITIS which is commonly seen in people who do heavy manual labor or do repetitive lifting all day long.    You likely have low back pain symptoms. With this report, I would encourage you to speak to your doctor about getting started in a PHYSICAL THERAPY program that encourages movement and stretching exercises (even though it will likely be a little uncomfortable) since these will be very good for you in the long run.    From what you've presented I do not see you as needing any type of surgery at this point. I also am not a provocative fan of "back injections" since their effects are highly variable and of relatively short duration in the patients that I see in my office and hospital practices.    Other conservative forms of treating your back condition would be medications, Ultrasound/diathermy sessions, TENS unit, Acupuncture or if that's not your cup of tea, "dry needling" and lumbar traction.    I would not encourage you to do epidurals, facet injections, vagal stimulators, or surgical procedures at this juncture but would very much promote exercise, good diet, weight loss and conditioning to strengthen core and back muscles, stop smoking (if you do), and maintain learn about keeping good posture while sitting, standing, and even walking.  Hope I have answered your query. Let me know if I can assist you further.  Regards, Dr. Dariush Saghafi, Neurologist