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

### input:
Hello Doctor, I have been suffering from lower back pain for last 4 weeks. I was told that i am suffering from muscle spasm and need to take rest. I was asked to do some stretchable exercise, physiotherapy and hot showers on the affected area. But till date I have not got any relief. Now I am not able to walk independently and it hurts a lot while walking few steps. Please advise. PADMA

### output:

DEAR PAD MA, HI, I AM Chat Doctor. I WOULD LIKE TO HELP YOU.  ASSUMING THAT YOU HAVEN'T STARTED USING A NEW PAIR OF PARTICULARLY HIGH HEELS AND YOUR OCCUPATION DOESN'T INVOLVE SITTING FOR LONG DURATIONS, YOU WILL HAVE TO GO BACK 4 WEEKS IN TIME AND TRY TO REMEMBER WHAT YOU WERE DOING IN THE EXACT MOMENT THE PAIN STARTED .THIS WILL GIVE YOU A CLUE AS TO WHAT THE CAUSE MIGHT BE SINCE THERE ARE MANY REASONS FOR LOW BACK PAIN WITH MUSCLE SPASM. MUSCLE SPASM IS USUALLY THE BODY SWAY OF PROTECTING THE VERTEBRAL COLUMN FROM FURTHER INJURY BY LIMITING YOUR ACTIVITY.SPASM CAN ALSO BE CAUSED BY SOMETHING THAT IRRITATES THE MUSCLE.FOR EXAMPLE IF YOU WERE INTO SOME HEAVY LIFTING, OR JERKY TRAVEL, OR A FAST MOVING SPORT YOU MAY HAVE SLIPPED A DISC ...IN WHICH CASE YOU MAY HAVE TO GO FOR A X-ray/CT/OR MRI AS YOUR ORTHOPEDIC IAN MAY Advise. IF IT STARTED AFTER A FALL OR AFTER SOMETHING FELL ON YOUR BACK YOU MAY HAVE SOME INJURY TO THE BONE WHICH CAN ALSO CAUSE MUSCLE SPASM I ALSO WANT YOU TO THINK IF YOU HAD ANY OTHER SYMPTOMS BEFORE OR AFTER THE PAIN STARTED LIKE A FEVER, AN ABDOMINAL PAIN, DIARRHOEA, URINARY INFECTION, ANY VAGINAL INFECTIONS OR EVEN A CHRONIC COUGH, ETC BECAUSE THERE IS AN INTRA-ABDOMINAL PATHOLOGY CALLED A PS OAS ABSCESS THAT IS SO PAINFUL THAT IT CAN EVEN STOP YOU FROM PUTTING YOUR FOOT DOWN DUE TO THE PAIN.  SO IF YOU HAVE NOT GOT ANY RELIEF FROM YOUR PAIN SINCE 4 WEEKS I THINK IT IS TIME FOR YOU TO GET A SECOND OPINION PREFERABLY FROM A QUALIFIED ORTHOPEDIC IAN.AND PLEASE BE WARY O F DOING EXERCISES AND PHYSIOTHERAPY UNTIL YOU CONFIRM THE CAUSE OF YOUR BACK PAIN.