<s>[INST] I have severe pain in my shoulder, all areas as well as the back of my neck. The pain radiates into my ribs and down into my hip. I have scoliosis which was detected recently. Did not have it as a child or at all until now. My rib is protruding and obvious to the sight. I had a rotator cuff surgery two years ago which included a major surgery with five anchors. My tail bone hurts now from a fall I took a month ago. The x-ray showed in my spine at that time of the fall that I had two compression fractures that were old. I did not know I had them. I can t sleep and the pain is horrible . [/INST] Your lower back pain could be related to the compression fractures or from local inflammation that developed late. There are a few options for managing this pain1. I would recommend a repeat X-ray of the spine to exclude any changes in the bones since the original fall (since the last X-ray was one month back its possible things have changed since then)2. Physical therapy is often very helpful and can be tried3. In terms of medications, you could try Acetaminophen (Tylenol) 325-650 mg every 4-6 hours as needed. Do not take more than 3,000 mg of Acetaminophen over a 24-hour period. You can also try Ibuprofen (400-800 mg three times a day with food)- it has an anti-inflammatory effect. Do not take Ibuprofen if you have a history of chronic kidney disease, bleeding from your gut or severe reflux. Since the X-ray will need to be ordered and interpreted by a physician, I recommend you see your primary care doctor too. </s>