<s>[INST] I have extreme lower back pain, excruciating when going from a sitting/lying to standing position.i received tramadol HCL 50 mg tabs from the ER. Can I also take acetaminophen HCI p m with it. You see, I went to bed at night but keep waking up in pain everytime I roll. Thanks in advance for your answer! [/INST] Hello, I have studied your case. First possibility could be lumbar canal stenosis leading to pain in your back. Due to compression of this nerve root there can be leg pain associated with it. I will advise you to do MRI spinor these symptoms analgesic and neurotrophic medication can be started. Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help. Physiotherapy like ultrasound and inferential therapy will give quick relief. I will advise checking your it B12 and it D3 level. Vascular claudication can also lead to leg pain which is common in smokers. Hope this answers your query. 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. </s>