<s>[INST] I have just been told that my 3rd 4th and 5th vertebrae are deteriorating, I have been told to take fish oil and panadol osteo how ever I still have some pain. Finding it hard to sleep at night. Need my sleep as fulltime carer for my husband. What do you advise? Thanks Ann [/INST] Hello, Might have been useful to mention your age and medical history as they influence medication recommendations. Such spinal changes as those you mention are common in many people with age. Management consists of over the counter anti-inflammatory medication like Ibuprofen and physical therapy. So you may use Ibuprofen in the evening but is not advised for prolonged periods as it may affect the kidneys, stomach and blood pressure. Hope I have answered your query. Let me know if I can assist you further.   </s>