<s>[INST] A few days ago, I pulled my lower back quite badly. Since then it seems to be healing with rest, ice and gentle exercise. However, a simultaneous problem has occurred that is causing a great deal of pain. I noticed that my bottom was also very painful, and when I looked there was a red and painful lump at the entrance to my anus. I took this to be a haemorrhoid. However, it is a very swollen and red perineum that is actually causing the pain. Is this related? Are they related to my back? And how can I treat it? At the moment, the combination of injuries means I can barely sit or sleep. [/INST] Thanks for your question on Chat Doctor. I can understand your situation and problem. I don't think your back pain and swelling at anal region are associated. By your history and description, your anal region swelling is mostly due to boil (skin infection). It is common in diabetic patients. So first rule out diabetes. Also consult surgeon and get done clinical examination. You need incision and Chat Doctor.  </s>