I'm sorry to hear about your ongoing low back pain and sleep difficulties. Small bulges in the L4-5 and L5-S1 discs can cause discomfort by pressing on nearby nerves, which might explain your symptoms.

Here are some steps you can consider:

• Pain and Inflammation Management: You are currently taking Tolpa D Tablet, which contains diclofenac (a non-steroidal anti-inflammatory drug) and serratiopeptidase, to reduce pain and inflammation. Ensure you take it exactly as prescribed and report any side effects like stomach upset to your doctor.

• Sleep Issues: Since your sleep is disturbed despite medication, it’s important to discuss this with your doctor. Poor sleep can worsen pain perception and delay healing.

• Physical Therapy: Engaging in guided physical therapy can strengthen your back muscles, improve flexibility, and reduce pressure on the discs.

• Lifestyle Modifications: Avoid heavy lifting, prolonged sitting, and practice good posture. Incorporate gentle exercises like walking or yoga as advised by your specialist.

• Further Evaluation: If pain and sleep problems persist, a consultation with a spine specialist or neurologist is recommended. They may suggest additional treatments such as nerve blocks, advanced imaging, or other interventions.

Please consult your spine specialist or neurologist promptly to review your treatment plan and address your sleep concerns effectively. If pain worsens suddenly or you develop symptoms like numbness, weakness, or bladder/bowel issues, seek emergency care immediately.To narrow down potential causes, we will need some more information.I understand you're dealing with back pain and sleep issues. To help me understand your situation better, could you please share your age and gender?