The issues raised in MRI scan are answered below 1- Sacralisation of L5- nothing to worry about, It is just a part of normal variation. That is not causing any problem. 2- diffuse disc bulge will have to be considered along with symptoms and seen if it is the cause of the problem. If it is only back pain your brother is suffering from then this disc is not causing any issue what so ever. If he has leg pains specifically left sided leg pain and the pattern of pain is along the right lines then intervention/treatment will have to be considered. Injections will not help for back pain only in the long term. Work on improving the strength of back by core strengthening exercises and yoga. Stretching is good but add exercises along with it. Painkillers and hot fomentation as needed. Maintaining a good posture and using a good supporting mattress is useful as well. Hope this helps. Dr Vinu Raj Consultant Spine Surgeon MBBS MRCS FRCS(Trauma&Orth)

All spine related issues in 28yrs of age are relates to posture and lack of proper strength in the core muscles. Along with stretching exercises I recommend your brother should start working on good postural alignment habits and strength training for muscles of lower back ..Only strength training is going find a solution in this case ...Consult a Physio near by he will guide properly how to practice safely ,instead you replicating by seeing in some website. All the best

Exercises regularly.  Sending you the link of the same below https://play.google.com/store/apps/details?id=com.backpainrelieving.backpain Or you can search for " back pain relieving exercises by kavin khatri " on google playstore