Conversation: The conversation between human and AI assistant.
[|Human|] I have a bad back & took a fall in a public facility when I walked into a restroom with over flowing water. I have a hematoma on my elbow & tonight my back is feeling like a painful heartbeat. What has suddenly happened? The fall happened a week and a half ago. I am a Coumadin patient so my options are limited. I had a cat scan on my head but no bleeds. My back was not checked out. Why would pain start a week later?
[|AI|]  Dear patient Back pain after trauma needs to be taken with care and investigated.  As you have got significant trauma possibility of minor fracture needs to be ruled out.  Back pain after a week might be due to muscle spasm or infection of the hematoma. Are you having fever ? If yes than abscess may be there. I would advise X-ray of lumbosacral spine anteroposterior and lateral views to rule out bony abnormalities.  Ultrasound of back is also advised to rule out collection. Start tab diclofenac plus serratiopeptodase combination twice a day for pain relief.  Also start antibiotics. All the best.