Acute lower back and shoulder pain, especially when related to the neck, is often due to muscle strain or nerve irritation from conditions like Cervical Spondylosis, and with Osteopenia, bone strength is reduced, which can worsen pain. Since physiotherapy has not helped, management should include a combination of doctor-guided pain relief (such as paracetamol or carefully selected medicines that are safe with your asthma, diabetes, and blood pressure), posture correction, ergonomic changes, gentle supervised exercises, and adequate calcium and vitamin D supplementation to support bone health. In some cases, doctors may advise imaging (like X-ray or MRI) to check for nerve compression and consider treatments such as stronger medications, targeted injections, or specialist referral. It is important to avoid self-medication (especially NSAIDs without advice, as they may affect your other conditions) and to have a personalised treatment plan to safely control pain and improve function.