Hi there!
The main issue is at L4-L5 with disc bulge causing compression of the thecal sac and the nerve root. If it is just mild compression it may respond to conservative measures like rest, pain killers/ anti-inflammatory medications and physiotherapy. For moderate to severe cases surgery may be required to relieve pressure on the thecal sac and the nerve roots. I would suggest discussing the management plan in detail with the treating orthopedician/ neurologist.
Hope this is helpful.
Take care!
I had similar MRI report. I had to have lower back surgery 7yrs ago. My lower back started bothering me at the same age. I would suggest a neurosurgon to go to. I had physical therapy, traction,pills, u name it I tried it. Just to get out of the pain I was in. I ended upafter several yes with a double herniation and in emergency surgery. I'm not trying to scare u, but even complete bed rest to get the disc to go back in doesn't always help. I experienced burning, tingling down my butt into my legs and feet. There is no magic to repair a disc only to be taken out or shaved off the sciatic nerve. I also had neck surgery br this lower Back surgery. Good luck I hope this helped