<s>[INST] Hi doctor, My mother who is 63 years old, suffering from back pain. She is not able to walk even 100 meters. After walking a short distance, she feels numb in her foot and needs to sit for some time to proceed further. While sleeping, she feels needle pricking like effect in either side of her back. My mother was a fish seller till her age of 61 which involved lifting fish box. Now for the past two years she is not going for work. Though she is active at home, is not able to walk as before. Last year, I consulted a bone specialist nearby our town. But after consulting him she is not even walking 100 m. Before that she used to go to our nearest town walking around 1 km. I have attached the previous consultation reports. The doctor had also done some blood test. Most of the blood tests were normal including blood pressure and blood sugar. But there is a slight increase in gamma globulins. I have attached her back x-ray too. I am much worried that after consultation her problem has increased. Please guide me further. [/INST] Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. Thank you for uploading the lab reports (attachment removed to protect patient identity). Her main issue is her back pain with back bone problems. She has got kyphosis (outward curvature of spine-hunch back) in the lumbar vertebral region. She has got the narrowing of the intervertebral spaces due to age related degeneration of the intervertebral discs at many places. In simple words, she has got issues with cushions that are naturally placed between the two vertebrae of the backbone for properly supporting the body weight. There is no big issue with gamma globulins and that slight change has no impact on her overall health. 1. Improve her diet by giving her plenty of water, salmon fish and a good amount of fruits and vegetables. 2. Give her tablet Acetaminophen (Paracetamol) for pain reduction. 3. Lumbosacral corset for supporting the back and to reduce the pain. 4. Apply Voltaren (Diclofenac topical) gel, massage gently and apply heat pad for soothing effects. 5. Apply ThermaCare heatwraps on the painful and pins and needles sensation areas. 6. Give her by mouth capsule Lyrica (Pregabalin). She will feel much better. Proper rest is necessary for her. If you feel nothing is helping her anymore, please consult a good orthopaedician to get a detailed physical evaluation after an MRI and get the treatment according to that. </s>