Problem: A 64-year-old woman presents for evaluation of eight weeks of pain in the left lower back with radiation down the left buttock lateral left leg and into the left foot. Her medical history includes by diabetic nephropathy and stage four chronic kidney diseases, coronary artery disease, a history of peptic ulcer disease and significant gastrointestinal, bleeding, uncontrolled hypertension and depression. The patient reports that she with a surgeon, but she because of the surgical risk associated with her medical she has been taking Tylenol, 1000 mg three times daily, but has not had any relief from the pain. She also saw physical therapist, but found it difficult to do the recommended exercises because of the pain. She reports no weakness and no bladder bowel dysfunction physical exam examination does not reveal any focal neurological deficits and an MRI demonstrates the 2 mm post their lateral L4 - five disc herniation within impingement. Need Assignment Help?