** 1. Piles are mainly due to cause and effect of Constipation, so make sure you are taking care of the same [take trifla churan at bed time with luke warm water] 2. Endocrine disorders like under active thyroid, disturbed blood sugar can also lead to constipation with resulting piles [please check with the values] 3. Do not strain while passing stool,and use WARM water or wet toilet paper but without perfume or alcohol(without soap) to clean your anus after each motion . Avoid cold/tap/jet (western seat) water. 4. take: elephant yam, papaya, butter milk, pistachio, almonds, pear, apple, old rice, milk, crystallized sugar, raw radish and avoid tea,coffee,garlic, onion,fish, hot spices, sitting for long hours. . eat slowly,avoid haste-irregular eating and sweet/heavy food which are difficult to digest and cause indigestion. . take less of strong spices (ginger,garlic), oily-fried-fatty food and flatus producing foods (peas,beans,dals) . fried cumin seeds 500mg, fried asafetida (hing) 125mg, shweta parpati 500mg, mix them and take with honey three times a day. . 1 glass lukewarm water every morning and night. . to stop bleeding [if there]: take coconut water from 1 coconut and add 2 table spoon full (tsf) sugar and drink. . Trifla because of its high nutritional-detoxification [Shodhan] and cleansing value is very helpful in treating your present complaints. [take 3 gm with luke warm water at bed time] PS: . Again piles, is due to low digestive fire and taking amla & aloe vera juice will help in cleansing the liver to speed up the metabolism. . According to the Arthritis Foundation, either heat or cold may help with pain-it may be a matter of trial and error to find which works better for you. . Back Pain could be due to being overweight [80Kg], thus seek an opinion of Spine Specialist for necessary Examination and also one has to focus on Weight Management Programme.