<s>[INST] i m having unexplained pain all over in my joints and my lower back gets muscle spasms and is very painful. i m always tired and feel deprived of sleep even though i get 7 to 9 hours of sleep a night. i have days where my muscles all over feel very weak and i get numbing and tingling sensations in my legs and between my shoulders. i have been getting bruises on my outter thighs as well. everytime i go to my doctor she thinks i m crazy and thinks its all in my head she even put me on cymbalta 60 once a day. all of my blood tests and mri s are normal. [/INST] Hi, The pain and spasm you experienced can be due abnormal nerve impulses or irritation. That is why your doctor had prescribed Cymbalta(Duloxetine). This should be taken for long term to get effect and you should have a regular follow up with your doctor. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Nishad BN </s>