<s>[INST] About 2 weeks ago my upper arms became so sore and lifting my arms caused pain. I have spasms in them if I move them a certain way. My lower back feels like knives are stabbing me, about 5-6 inches below my waist. It moves from one side to the other. I am normally an energetic person, but for the last few weeks have had a lot of fatigue. I also have been on a z-pak for a chronic cough, that started after my husband had a bout of ? Bronchitis. I did develop a parasite this past summer, and bowels have been different ever since. This is all strange for me! I feel yukky, and I m not sure what to do, or who to see. Thanks, Carla [/INST] Hi, It can be due to spine related problems like a prolapsed disc. Consult an orthopedician and plan for an MRI scan. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician </s>