<s>[INST] I am a 23 year old female who hasn t had any injuries. My lower back is very very painful and tender to touch in a small fist sized area. The pain has lasted over 4 months now but this month has become increasingly worse and sometimes unbearable. I usually have a high pain threshold but this is very painful. Any ideas what it could be? Pain killers only provide temporary relief. [/INST] Hello,I had gone through the case and found that history of symptoms are missed like whole back or only in spine, radiation of pain, other symptoms like numbness .So there might be many cause-Herniated discSciaticaOsteo arthritisVitamin D3 deficiencySlip disc very common.So go for MRI of Vertebrae , blood test of Vitamin D3 and diagnose the cause and take proper treatment by Orthopedic Doctor.Meanwhile apply Hot water bottle massage and muscle relaxant gel. Do not try to bend and take rest until diagnosis is not sure. Do not try any exercise.Hope my answer will be  effective for you.Thanks & Take care </s>