<s>[INST] Hurt my back in a fall in 2001. Muscle injury was said to be the cause of my pain. Spine has been checked and is not the problem. Pain is very bad, can not work very much if at all. Tried massage, many physio places, chiro,trigger point needling,acupuncture,reflexology among other things. Taking oxyneo 10 mg2x a day,oxycocet as needed0-2/day Best in the mornings and gets worse with walking,sitting,bending,twisting and movement that I use hips or lower back. Any ideas? [/INST] hi,thank-you for providing the brief history of you.As you had injury of spine in 2001, this could have made the muscle weaker. as too many therapies you have undergone and all have different principles of application.Massage - this will produce vasodilation and reduce pain but even weaken the muscles.Chiropractor - this will help unlocking the facet joint and reduce the joint induce pain without strengthening the muscular system.etc etc therapies have their effect. Physical therapy, now you need a proper neuromuscular assessment with focused in the spinal injury and then a proper rehabilitation plan should be implemented.Usually in my clinical practice we do get chronic pain of spine cases but with proper implementation and long term planning of the various areas to strengthen have helped our patients to better comfort.I will advice to find a spine specialist physical therapist who can. reassess the spine and provide the best outcome to your overall body strength.RegardsJay Indravadan Patel </s>