Hi, I'm a 23 year-old student with chronic lower back pain for over three years now. Two years ago, through an NHS physio, I had an MRI scan which showed "moderate  sized  central  disc  protrusion  L5-S1  compressing  thecal  sac. Larger  L4-5  central  disc  protrusion  causing  substantial thecal sac compression". After this, I had a small amount of NHS physio and recently a bit more - which has not helped much due to the rushed pace of their clinics has left me confused. The trouble is I keep having painful radiating flares every month and in-between I have minimal/achy pain. The pain is unilateral radiating down one leg (mainly to the knee and anterior thigh). The pain is worst on walking and can stop me lifting my leg sometimes. Strangely cycling is perfectly fine. I feel that the pain is only getting worse and I am running out of options. What would you recommend? Many thanks, Chris

Hi Chris Poor you - but I’m sure there is lots that you can be getting on with. MRI scans are never a bad thing, but they can be prone to be over interpreted. After all we just don’t know what is normal and what is not. We don’t know what is the pain causing structure(s) and what is not - so you’ve had a scan, you’ve got some stuff in your back, but so what? You can’t change that BUT it doesn’t necessarily mean that it's the cause of your problem…. The function of your back is miles more important that the static structure - it’s not what you’ve got, but it’s what you do with it that counts. You like cycling as it puts your back into a nice curved position and alters pressure on lots of different structures - and it’s also exercise, and that’s great but, feeling better isn’t always the same as getting better especially if we follow the structural route… I’m not therefore sure if anyone has tried to change the cause of your pain, rather than just trying to chase your pain away. Core stability or strength or stretching just doesn’t cut the mustard. You need to change the why’s - and a great place to start is getting  more movement through your thoracic spine (away from you lower back and leg) to take away the excessive load and shear through your lower back - and this is about stability and control, but needs to be out in at the right place and right time in your rehab cycle. A picture (or video!) is worth a thousand words - have a look at some of these to get you going https://www.sixphysio.com/video/back-pain No quick wins, but try for the next few weeks and then get back to me…