<s>[INST] HI, I was wondering if you know anything about enlarged or low red blood cells in relation to low back pain in males. After having a bone marrow test, the white blood cells either became low or high. This is for my friend s Dad so I don t know the details, but everything is checking out fine everywhere else....Kidneys, colon, liver, spleen are all okay. I know this is really vague, but any hunches you might have would be helpful and appreciated. Thanks. [/INST] Hi, I had gone through your question and understand your concerns. I see similar cases amongst young people who visit my clinic. In the first meeting, I advise my patients to go on lifestyle modifications for three months. I retest them again after three months and if they continue to be in high range then I advise them to go take many physiotherapy modality like IFT and SWD OR TRACTION therapy by which we control the pain of lower back but there is no relation between back pain and low rbc values.... in fact due to some jerky movement and muscle spasm he may have this type of pain... </s>