### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I was hit with extreme ferocity almost 7 years ago and was knocked to the cement floor. I injured L3-S1. I have rods in back at L5-S1; however I had laminectomy w/o fusion from L3-L5. My mid back hurts terribly. I was diagnosed with a chest wall contusion and now have scare in my lungs.My midspine vertebrae are now moving closer to my front. I was told my spinal cord is ok. The pain is becoming excruciating. What can be done?

### output:

Hi, Thank you for providing the brief history of you. As you mentioned you had an injury 7 years ago and for which you underwent a surgery. Now, since you have a pain in your mid back region, I will suggest you to take some ultrasound therapy via the physical therapist. Also, you need to do regular breathing exercises, As breathing exercise is not only going to move the rib cage but also the thoracic vertebrae as well. As your spinal is ok, may be your physician must have told you this, we need to look for the exercise rehabilitation which can help ease the pain. As you should know that the thoracic vertebrae which is your mid back region, these vertebrae do not have many movements except for a few degrees of movement. You must be having a para spinal muscle spasm which can be helped with ultrasound therapy, Physical therapist will perform this. Post that a rehabilitation plan to be implemented in two formats1. Short term goals2. Long term goals. Short term goals, Reduce the pain improve respiration increase strength in upper and lower limbs Long term goalsFocus on core stabilityImprove shoulder girdle musclesStrengthen the spinal muscles the long term goals, You need to keep practicing this exercises as you should always safeguard your spine. Due to the injury of the past, The physics of the load bearing spine has been modified. So a proper care is always a good way to good health hope to see you cheerful soonRegardsJay In Chat Doctor. 