What is your recommendation for my father's back pain?

Hi,

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You have mentioned that your father has been suffering from lower back pain since four months and it appears that he is on homeopathic medications for his pain. There are many causes of pain in the lower back region. It can be due to faulty posture, related to weak muscles, issues with intervertebral disc, narrowing of the spinal canal, any bony instability besides many others, etc. So, accurate diagnosis is the key to the proper management of the condition. You will have to elaborate on your father's problem as a detailed discussion of his back pain, which means duration of pain and mode of onset. I would also like to ask you if it is associated with any radiating or traveling leg pain or any other neurological symptoms like numbness, paresthesias (electrical shock-like abnormal sensations), or any weakness in limbs. Please also tell me about any associated symptoms like fever, weight loss, etc. You have sent me an X-ray report (attachment removed to protect patient identity), which shows degenerative changes in the lower back and it is expected at this age. If your father has localized back pain with no other symptoms like radiating leg pain and neurological symptoms, then you can start with the following treatment recommendations for an initial period of two to three weeks with the consent of your specialist doctor.

1. Maintain proper posture of his back while working and sleeping.
2. If pain is more, then he can take a short course of an anti-inflammatory medication, which suits him.
3. Physical therapy initially under the supervision of a trained physiotherapist and then continues at home.
4. Adequate calcium and vitamin D intake, if levels are low in the body.
5. Ice packs can be applied if your pain is acute and then hot fomentation can be done at home.
6. Analgesic spray for local application can be used and is easily available.
7. Avoid lifting heavy weights or acutely forward bending in the morning, etc.
8. We will observe him for the next two to three weeks how you respond to this conservative management protocol.
9. If he did not feel better, then we will have to get some investigations. X-ray lumbosacral spine AP (anteroposterior) and lateral - flexion and extension views and MRI LS spine.
10. Also, briefly tell me about the medical history and any other treatment history of your father in the past.