What can be done for a posterior annual tear with a bulging disc at l3/4? finished pt, taking lots of meds for pain. disc bulge abuts the thecal sac.

Back pain: For annular tears a back brace and medial branch blocks at the L3/4 level may help. Core exercises to strengthen back and abdominal muscles will provide an internal brace. Chiropractic care may provide a benefit where physical therapy did not. If the nonoperative treats fail to relieve the pain and there is significant disability then surgery would be the next option.