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

### input:
i am a 61 year old male, 6 230 lbs. I have had lower right back pain for 5 weeks now. I went to my doctor and got pain meds and muscle relaxers, which didnt seem to help. I noticed it seems harder to urinate and I have a weaker stream and I reported back with that a couple weeks after the first visit and she prescribed antibiotics and ordered a PSA test whicChatDoctore back normal at .30. For the last couple of weeks my pain is very mild during the day, but when I go to bed I can only lie on my left side and I awaken after 2-4 hours and can not get comfortable in any position and so I switch to my recliner and can sleep in it pretty much pain free the rest of the night. This has happened every night for the last 2 weeks. We have a sleep number bed and I have tried soft to very firm settings and it doesnt seem to matter. I can only stay in bed a few hours and then the pain sets in, yet I dont have pain in the recliner. i am not sure if the urination change has anything to do with it. It is just a slightly noticeable change and bowel habits are normal. Just wondering what I should have checked out next, or if this is something I am going to have to live with.

### output:

Dear patient two things can be ruled out from your history is prostatic hypertrophy because your PSA is normal and muscular backache because you are not relieved by muscle relaxants. I would like to do X-ray of the lumbosacral spine anteroposterior and lateral views to rule out bony pathology. If it is a normal MRI of the lumbosacral spine will be very helpful as it is highly sensitive and specific for spine pathology. Please get it done at the earliest possible time from radiology center nearby you. Meanwhile, start tab attract twice a day for pain relief. Visit to urologist to rule out urethral abnormalities would be recommended.