Dear XXXXXXX,
Thanks for posting your query.

It seems you have been suffering from back pain since long and have not got relief with whatsoever treatment you have recieved in past. To get rid of the pain permanently, you must first identify its source. The history you provided suggests you have a disc prolapse at certain level/levels that causes compression over nerve roots/ spina cord/ both. With medications and physiotherapy you had some relief but not complete.

The first step is to confirm the diagnosis. This can be done by thorough clinical examination and supported by relevant investigations. MRI is the investigation of choice and gives fair idea of amount of disc prolapse, its level (cervical/thoracic/lumbar), and possible line of treatment (conservative/surgical).

Conservative treatment comprises of rest, medications, lifestyle modifications and physiotherapy. Lifestyle modification means improvements in posture, work habbits, eating habits, sleeping habits, sport etiquets and avoiding certain activities like smoking, drinking, excessive atheletic acitivity etc. Physiotherapy is in form of traction, IFT/SWD and back strengthening exercises. These exercises by far are the only long term mainstay in complete cure of this illness.

Surgical intervention is required if all of the above has failed. It usually comprises of conventional nerve decompression surgery, either open or through minimal invasive procedures.

I hope this answer shows you the right direction. For any further queries, I'm available for follow up.
Regards.

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