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

### input:
I am taking 500 mg Metformin (1 pill) twice a day.  In an effort to lose weight I increased my walking.  I am having low back pain - when I stand up from sitting, and occasionally a spasm when standing.  A heating pad helps.  I thought Iincreased the walking too suddenly, but now wonder how this condition is interacting with diabetes/metformin?

### output:

Hi, I have read your problem. Usually back pain is managed with painkillers till 1-month period. If it persists beyond 1 month, then further investigations are done. Since you have a bad pain I will suggest the following: - Back pain can be due to many reasons, and it has probably no relation with your metformin alone but, if taken with statins then it may cause back pain. You should get x-ray lumbosacral spine done in AP and Lateral done send us report or discuss it with your doctor. Only then further management can be advised. - Avoid heavy weight lifting pushing and pulling heavy objects, because it will further increase back pain. - You can take medicine like painkillers + muscle relaxants by discussing it with your doctor. You may need stronger painkillers which are available on prescription only. You can try ibuprofen or naproxen till you see your doctor. - Apply hot packs for 30 min in morning and evening. I hope it helps. You are welcome to ask further health related queries. If you have any further query, I would be glad to help you. If not, you may close the discussion and if possible you may rate the answer 5 points for me, so that I get good feedback. In future if you wish to contact me directly, you can use the below-mentioned link: http://doctor.ChatDoctor .com/doctors/ Chat Doctor.  Thanks.  