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

### input:
I started having pain on my lower right side of my back a few weeks ago. I have been tested for stones, UTIs, vaginal infections, STDs, and appendicitis, and all were normal. Because I was also having bladder urgency problems and retention and right abdominal pain. A few nights ago I started getting really sharp, intense pain at the top of my left toe, it only lasts a few seconds and then stops . I then started having back pain on both side of my lower and upper back so severe I find it hard to breath, and it wakes me up at night, but goes away after a short time and then comes back. Then yesterday, I started having really horrible tailbone pain and found it hard to sit or stand or lay down. I feel the urge to go to the bathroom and I have no luck getting anything out and it hurts my back like crazy to try. I looked at my bottom in a mirror and it doesnt look like a hemorrhoid, it looks more like skin grew over my anus and now there is no view of a hole anymore and there is a red streak that started out small this morning and now it has spread up to my spine from the aaus and I feel excruciating pain when I sit, stand, lay or even try to go to the bathroom in my spine and hips. I also have been experiencing muscle spasm type feeling through my legs whenever I get up from sitting, it is also very painful and it has been going on for about 3 weeks,and the pain can last for hours. I have no idea what to think any of this is. I know I am not pregnant, I have been tested and  I have started bleeding a few minutes ago from what I hope is my period. I have fibromyalgia, IBS, Interstitial cystitis, Migraines, and Bipolar as my history. I have been taking Neurontin and elavil though for those things.

### output:

Here you have told as per your past and current history you have irritable bowel syn Chat Doctor.  Now recently you have started developing back pain along with muscle spasm feeling in your leg. Here your back pain can be related with multiple issues. It can be due to fibromyalgia where it is affecting your spinal muscles, it can be due to IBS where due to over strain on soft tissue it is causing pain, it can be due to problem at lumbosacral spinal level where there might be issue at lumbar spinal curve or disc related problems disturbing the nerves coming from. That particular level, it can also be due to interstitial cystitis which is disturbing the soft tissue and creating more inflammation in soft tissue.However the conformation can be done by MRI of lumbosacral spine and physical test examination by orthopedic doctor. As per the report and orthopedic examination, or tho doctor will suggest you either surgical correction for severe damage in spine and disc or conservative management with physiotherapy treatment and exercises for mild to moderate issues. Here if you have any issue with your digestive system as well for passing motion then you can also check once with Castro neurologist. For back pain you can also use hot and cold pack to have some more relief at home itself. As well do take suggestion on postural correction and physiotherapy spinal exercises properly. This will help to improve strength and stamina of your spine. If your MRI is normal, and it gets conform that back pain is due to fibromyalgia. I suggest first keep some rest to body and mind, do Panama and yoga to heal body from inside. Along with this again physiotherapy treatment and suggestion will help you a lot. Also do changes in your lifestyle like keep food habit regular and have simple food with Lora of fruits and fiber, maintain sleeping time etc. Take care.