Patient presents with complaints of chronic back pain consistent with multilevel degenerative disc disease.  The patient reports experiencing  intermittent radiating pain, numbness, and tingling, as well as stiffness and limited range of motion.  Symptoms impact activities of daily living, including walking, bending, and sitting for extended periods.  On physical examination, the patient exhibits tenderness to palpation along the lumbar spine, paraspinal muscle spasm, and decreased lumbar flexion and extension.  Neurological examination reveals intact reflexes and no significant motor weakness.  Radiographic imaging, including lumbar spine X-rays and MRI, confirms multilevel disc degeneration characterized by disc space narrowing, osteophyte formation, and facet joint hypertrophy at L3-L4, L4-L5, and L5-S1.  Differential diagnoses considered include lumbar spinal stenosis, facet joint syndrome, and spondylolisthesis.  The diagnosis of multilevel degenerative disc disease is supported by the patient's history, physical examination findings, and imaging studies.  The initial treatment plan includes conservative management with physical therapy focusing on core strengthening, flexibility exercises, and pain management strategies.  Pharmacological interventions may include NSAIDs, muscle relaxants, and neuropathic pain medications.  Patient education regarding proper body mechanics, posture, and activity modification will be provided.  Referral to a pain management specialist or spine surgeon will be considered if conservative measures fail to provide adequate symptom relief.  Follow-up appointment scheduled in four weeks to assess treatment response and discuss further management options, including potential interventions such as epidural steroid injections or surgical consultation if necessary.