Conversation: The conversation between human and AI assistant.
[|Human|] I am 29 year old/ male, an occupational health nurse working in UAE on a construction site. I was recently married and  rejoined here 2 months ago.  Suddenly one day I was having sciatica pain on the left leg for 2 days and it shifted its location to right side after 2 days and it continued for another 5 more days. I underwent an MRI as per my orthopedic doctors advice and the report shows that i am having degenerative disc disease on the lumbar region. This is the MRI report:- MRI OF LUMBAR SPINE Indication: Low backache radiating to bilateral lower limbs (R>L) Technique: MRI of Lumbar spine was done on 1.5 Tesla Scanner in multiple planes and using multisequence technique. Patient given Soft copy of MRI study Findings: Straightening of lumbar spine noted. Marginal osteophytes noted at L3-4 level. Transitional vertebra noted (sacralization of L5). The vertebral body heights are maintained with normal marrow signal intensity pattern. Disc desiccation with posterior diffuse disc bulge and annular tear at L3-4 level mildly indenting thecal sac and moderately narrowing bilateral neural foramina. Disc desiccation with posterior diffuse disc bulge at L4-5 level minimally indenting thecal sac and narrowing bilateral neural foramina. Rest of the intervertebral disc normal. Facetal joints normal. Pedicles, laminae and spinous processes are normal. Visualized spinal cord, conus medullaris and thecal sac are normal. Both psoas muscles are normal. Both sacro-iliac joints are normal. Pre and paravertebral soft tissues are normal. Opinion: Degenerative lumbar spine disease with Disc desiccation with posterior diffuse disc bulge and annular tear at L3-4 level mildly indenting thecal sac and moderately narrowing bilateral neural foramina. Disc desiccation with posterior diffuse disc bulge at L4-5 level minimally indenting thecal sac and narrowing bilateral neural foramina. I am not on any medication because the pain was lasted only for 7 days. Now i am absolutely pain free and i am able to do anything. I am over weight and it is 112 Kg with 60 height. But I would like to know more about - 1) the problem what i have..??? 2) what will be managements ..?? 3) what are things i should take in consideration to avoid further damage..??? 4) Is there any cure for the disease..??? 5) What are the things i should keep in mind before intercourse...??? 6) Will sexual intercourse make further damage to the said problem...?? Please help....
[|AI|]  I read your query carefully, and I understand your concern. The report indicates diffuse degenerative changes of the lumbar spine and a herniated disc at the L3-L4 level which causes narrowing of the neural foramina thus compressing the nerve roots bilaterally, data which corresponds to your symptoms. The first step in treatment is physical therapy and painkillers like Ibuprofen. If symptoms don't subside local injections with corticosteroids and anesthetics are the next step. If still no success surgery could be considered, at times even earlier if there are new signs like motor weakness, saddle-like distribution sensory changes and micturition problems which could indicate caudal equine compression. You should also avoid heavy weight lifting if that is the case in your line of work. I hope to have been of help.