<s>[INST] Hi DoctorMy wife has a small lump on her spine. However it is painful and she limbs while walking specifically the top of her right leg near the joint of the hip. He back aches in the day and at night.She visited a doctor and had her examined. However the Doctor reassured her that it is a muscular knot and she needs a deep tissue massage ?How can we be sure that it is not a tumor? [/INST] Welcome to Chat Doctor .1. Painful lump on the spine with back pain symptoms. 2. Painful lump will go in terms of an infective process - which needs attention.3. In this case an ultrasound examination will help in right direction. It will help to evaluate the nature of the lump, its source and extensions.4. If a mass lesion a needle sample would help exactly what cells are there.5. For back pain an MRI will be excellent investigation of choice.6. Initillay back exercises followed by physiotherapy will be the treatment of choice. Good luck. Hope it helps you. Wish you a good health. Anything to ask ? Do not hesitate. Thank you. </s>