<s>[INST] Hello, I am inquiring for my husband. Lately he has been tired all the time and is experiencing pain in the middle of his back. Sometimes shooting pain but mostly just sore and tender to the touch. He is active as well as a fairly stressful job. I was just wondering if there might be any medical reason for the correlation of these two symptoms? Thank you [/INST] HiS hooting pain in the middle of back shows lumbar vertebral involvement where some senile changes as well as caused by stressful work might be taking place. However, it could also involve sacral vertebra also. That he is feeling tired may be indirectly associated with inter vertebral stress and or anemia and/or mental stress. Further investigations of l/s spine x-ray AP Lateral view and blood for HE and sugar levels should be checked. I hope it indicates you well. </s>