Hi, Thanks for writing in. The lower back spine contains small bones aligned on top of each other with spongy discs between them. Between any 2 bones there are holes on either side through which nerves originating from the spinal cord pass through. Due to aging, the small bones develop bony outgrowths and the discs also degenerate. This causes pressure on the nerve roots and therefore the person feels pain in the area supplied by the nerve and in lower back. Your MRI scan is showing degenerative changes at more than one level in the lower back and this is maximum at L 4 - L 5 and L 5 - S 1 disc levels and this is causing pinching of nerve roots Initially you can try to avoid heavy physical activity and take mild pain relief spray and ointment. If there is pain even after using ointment then you can take oral pain relief medicines. Please avoid long term use of oral pain relief medicines. You can try physiotherapy sessions for comfort. If there is no significant pain relief after 6 months and worsening pain then you can take treatment with injections. Surgery is last solution when pain is severe however surgery does not help every patient and 40 percent patients continue to have pain and therefore surgery is to be carefully discussed with the neurosurgeon and to be done only if there is high chance of symptomatic improvement. Please do not worry.