Question
hello doctor
i am a 24 year male from India and my MRI report of date 29/jan/2009 says [u][b] Diffuse L3/4, L4/L5 disc bulge along with primary lumbar canal steno-sis compressing thecal sac & bilateral eciting nerve roots [/b][/u] sir i am suffering from back pain from  several year  it was ok from last two years but from last one month it is in very bad condition .i am a software engineer so have to sit in front of computer for mor than 8 hrs a day.i am 6 feet tall six months back my weight was 90kgs i was overweight then i started losing my weight by diet control and running on treadmill and different cardio exercises along with abs exerciser with some push ups and pull up and chin ups and littel bit of weight training and then i loss around 20 kgs in 3.5 months till that point of time i was feeling very confident about my back pain i thought that it has gone away with my extra weight  and then i started building muscles with  different weight training exercises at this time there was no back pain and i was ver very happy  after a month my back started paining that too very badly then i stooped working out  and started stretching at home which i learned from physiotherapist and internet got some referee from pain  then again i workout a littil bit again it come back now i had stop working out and doing stretching at home but pain is still there can you guide me what should i do what kind of workout is good for me, what specific exercises i should not do and i really want to be fit and built a some muscles because i had started looking very thin  as i  am so young  but not able to do that please doctor help me out  plz guid me what should i do  and how will i get ride of this pain and what are the thing i should not do at all and kind of treatment will help me to get back to my normal life routine i mean my office and gym without pain can you tell me what short of treatment or medicine will get me relief from this pain and last time i visit a spine doctor he ask me to bend forward  and then examine my back and then he said that u r fine u should do some  exercise that too very slowly and and died not give me any kind of medicine

Answer
Hello Ajay,
Sorry to hear about your serious back pain.  I am however encouraged  by your commitment to get better as shown by your recent weight loss and desire to get stronger.  AS frustrating as this may sound I cannot make a diagnosis as to why exactly you are experiencing your pain because I haven't examined you and the MRI alone does not have enough information to allow me to make that diagnosis and the corresponding treatment. I am encouraged that you had seen a physiotherapist. My suggestion is to return to the physiotherapist especially since you have lost weight and built muscle mass and tone. Now, if I misunderstood that you haven't actually seen a physio, but rather you saw one on a web site then I would encourage you to go to a chiropractor or a physio to have the examination and diagnosis with appropriate treatment.  After you have received a diagnosis you can click on this link to get to the media section of Back Clinics of Canada and you can find a video interview where some basic exercises/stretches are demonstrated:

http://www.backclinicsofcanada.ca/index.php?/backclinics/media/

Good luck and please rate my answer and nominate me as expert of the month!

Dr. Ron Nusbaum