<s>[INST] I am 42 year old female, overweight often have back pain.  I fell forward over two stacked milk crates, did not hear a pop or have immediate pain, however, 20 minutes later i was unable to walk without pain in the  lower left part of my back.  It seems like the pain comes when i twist my back in any way. There is no specific spot that hurts if I touch it and it does not feel warm.  I am used to back pain from stress and strain, but this feels different.  Should I ice it as if it is a pulled muscle, or heat it? [/INST] Hello dear,The symptoms as mentioned in your post can be attributed to muscle spasm secondary to the fall.Symptomatic relief can be obtained by taking analgesics like Diclofenac with serratiopeptidase (to be taken after food), application of analgesic+muscle relaxant ointment, ice compression & adequate rest.Physiotherapy therapy exercise will also be helpful.If symptoms still persist, kindly get an X ray of lower back done to rule out any pathological cause for your symptoms.Take care. </s>