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

### input:
Hello, Ive been having severe back pain for over a year now. I have had a x-ray done. I have been to physical theraphy for 6 weeks and neither helped. I dont have health insurance and i dont think my doctor is taking me seriously. The medication i take is Tramadol 50mg, Naproxen 500mg, and Diazepam 5mg. I have been on this medication the whole time. Im not a pill head and everytime i tell my doctor that these meds. or not helping she does nothing about it. I no that there is something not right. For the last week every night after midnight i am in pain for hours. My doctor told me i have muscle spasms. When the pain comes my whole back locks up. While im in pain i cant move, sit up, and dont wont to be touched. Almost everyday im in pain. I just want to no what is exactly wrong with me and how can i stop  the pain.    Please help me!

### output:

Hi, Thanks for your query. After going through your query I came to know that you are suffering from chronic backache.  It may be due to vitamin and trace element deficiencies specially vitamin D and vitamin B 12. You need to do MRI to rule out other causes. Back exercises, neurotrophic such as mecobalamine and analgesics (which you are already taking) give relief. Serum vitamin D test is advised if it is lower than vitamin D supplementation will be required. Avoid long continuous standing. Sit in a straight posture. You can discuss with your treating Doctor about it. I do hope that you have found something helpful. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care.