instruction: hello doctor for the last month I have been suffering with pain on my spine and lower back when I touch a specific point on my spine the pain is severe it hurts when I bend or sit it feels very sore I visited a go and she said that she thinks it is a muscle insertion that causes the pain but she is not sure she did a neurological examination and all was normal I wanted your opinion as my ankles and shin bone now started being painful too I was diagnosed with fibromyalgia four months ago and wanted to know if it is this that causes bone pain my posture is quite bad too so I am not sure what it could be I am very worried in case it is something very serious what I should do now
output: hello from your history and being unable to examine you I can only speculate on the cause yes fibromyalgia can lead to trigger spots like tender areas which can be over the muscle belly or their attachment on the bone the good thing was that the neurological exam was normal now coming to your concern that the shin and ankles had become painful I will recommend that you get your ear erythrocyte sedimentation rate cop reactive protein complete blood count abc urine routine vitamin levels and blood sugar tested this will generally show indication about any inflammatory process and bars on that you can be started on antiinflammatory medication including steroids and possibly vitamin too please let me know your investigation results