Conversation: The conversation between human and AI assistant.
[|Human|] I have diabetes high blood pressure and thyroid issues take medicine for all due to obmacare havent seen a dr in a while .My left leg started hurting me in feb. [doesnt feel like a blood clot ] now my hips and lower back hurt my urine doesnt hurt or burn I sick to my stomach and feel likes something is wrong
[|AI|]  Hi Thanks for your query and Welcome. I am Chat Doctor. You have mentioned pain in your back region with radiation of pain in the legs as well.Also, you have multiple co morbid conditions for which I am sure you are having adequate medical care. As far as your back is concerned, I need to ask you a few questions based upon which I can tell you what further needs to be done :- What was the cause of onset of this pain if you can recall it?- Duration of the back pain ?- Apart from your back pain do you also have any associated radiating leg pain, numbness, weakness in limbs, paresthesia etc. as well?- Any aggravating or relieving factors of your symptoms?- How much distance can you walk, and what are your analgesic requirements on a daily basis?- Is there any history of Fever, Loss of appetite, Weight Loss, Rashes over the body?- What investigations and management has been done till now for your existing problems? I can tell you that lower back pain could be due to many reasons, it can be due to narrowing of your spinal canal, disc issues, bony instability and facet arthropathy etc. But the majority of these conditions actually can be managed conservatively with Posture maintenance, physical therapy and medications. Although I am sure you have tried a lot of medications and alternate form of treatments, but till the time I can see your details, If you have localized back pain with no other neurological symptoms like numbness, weakness, paresthesia etc., then you can start with following recommendations for initial period of 2-3 weeks:- To maintain proper posture of your back while working and sleeping, try maintaining an erect posture as much as possible- If pain is more than you can take a short course of an anti-inflammatory medications which suits you like Ibuprofen, Paracetamol etc-Physical therapy initially under supervision of a trained physiotherapist.- Adequate calcium & vitamin D intake if levels are low in body-Hot fomentation can be done at home 3-4 times in a day, if possible-Analgesic spray for local application can be used after fomentation - Avoid lifting heavyweight/ acute forward bending in mornings and take adequate precautions till pain completely subsides.etc will observe you for next 2-3 weeks how you respond to this conservative management protocol. If there is no clinical improvement, then we will plan for your investigations including blood tests, X-Rays and if your back pain is a long-standing one, then MRI of lower back region. Do not hesitate to contact me if you need any further assistance/SOS with more clinical details and test reportsThanks & Regards