<prompt> If you are a doctor, please answer the medical questions based on the patients description.Hi, i had back surgery 2 years ago, discectomy on L4-5. Now i have back pain again with numnes and burning on my gluts and thights. I had an lumbar X-ray a week ago which shows moderate to severe hypertrophy on the lumbar facet joints and vacuum disk phenomenon on L4-5 disks. What causes this phenomenon and what is the treatment.I did hear about gel like substance injection to be added to the disk. How effective this treatment is?Thanks. Irina  <response>: Irina, all procedure apart from discectomy for these complain does not have a very strong scientific back up. I mean these procedures injection, or chiropractic may or may not work in every individual. I think if pain is tolerable than you can take it B 12 to make your nerves strong. Furthermore, I would also like to see MRI because X-ray diagnosis can be misleading. Avoid heavy weight lifting and forward bending. 