<s>[INST] Dear sir I have problem related to pain, muscle contraction, shivering. When i lift small weight or press any object with my hands my hands start paining in shoulder joint and hands shiver. When I fold my hand or leg it start paining in joint and muscle contracts. When I lift my hand or leg for little time pain is felt along with shivering. I can t move my body freely Some type of jam is felt.I feel shivering in standing position. My hand while writing feels shivering and I can t write freely. I consulted a ortho doctor he did blood test for vitamin B12, hydroxy vitamin D result was 190 & 10.49 is low. Medicine given are D360 capsule, Cobadex czsczs & nusran. Kindly suggest am I going in right direction. Aftab Alam. [/INST] Hi, Thanks for your query. Seems you are suffering from multiple joint pain - Polyarthritis with early morning stiffness. Rheumatoid arthritis is one of the most common causes for Polyarthritis. I would suggest you to get yourself examined by an Orthopaedician for multiple joint pains. You would be asked to undergo few blood tests like He, RBS, TLC, DLC, ESR, RA factor, CRP and Thyroid profile along with routine urine examination. These investigations will help us find out the exact cause. Discuss with your doctor. I do hope that you have found something helpful, and I will be glad to answer any further query. Take care </s>