<s>[INST] i have had bad low back pain for years all the time. I m tired all the time my legs go numb at times along with hands. also cold weather effects pain mre espically rain and snow and notice my hands shake at times along with twitching. I m trying figure what s wrong my mri came back normal. this low back pain has me depressed all the time I m 34 yrs old. do you know what thia could be? [/INST] My Dear :Lowe back pain is a huge subject, and it is more than that you are able to describe. The pain that you have experience needs more analysis special in your age. The pain in elderly due to a lot of reasons but in your age the limited and organic reasons has to be ruled out. Further questions needed to be answered like wither if there is any history of accident? How long this pain been there ? Any history of fever, chills and weight loss ? Any history of professional sports ? Any injuries at all ? Hands numbs goes along with back pain and cold weather, rain and snow make hands shake at times along with twitching .... This make the situation more interesting and required more information to role out hematological, vascular reasons. The back does not affect hand or vise versa. I think you need to somebody (rheumatologist) to get all of these questions answered. You might need simpler investigation than MRI, hematological blood work up to differentiate between the differential diagnosis ... </s>