Dear Doctor: I am 50 years old man weighing 96kg working as an emergency physician transfered reently to the G surgery dept.with no H/O chronic illness ,complaining of occasional low back pain for the last 3 months which is increased on long standing an hard work . I took 3 injections of voltarin for my back pain last year but unfortunatly not eliviate the pain for the last attack that lasted 1 week . Tje pain is spasm like increased on movement and decreased on lying down and after rest, I have tingling sensation at the right 2nd toe that coms and goes during walking or standing 3 months duration and I noticed that specially when I had weared a theatre shoes . I did an MRI to exclud disc prolaps but unfortunatly it reveals a paracentral focal disc protrusion causing S1 nerve root compression with nural oedema .and incidental sacral meningeal cyst at S2 level compressing right S2 nerve, I wander how my symptoms and signs are not applicable or corelate the MRI findings.and I want to know the problem exactly and the managment of such case .,may be I have 2 pathology one at the foot and the other at the disc. Thanks. I look forward to hearing from you soon. Yours Faithfully Dr,Mohammed Alabd