question: My name is Kelly and I am a 28-year old graduate student (Masters of Public Health program). My question has to do with a progressively worsening  condition that I ve been dealing with now for several years.  For the past 2-3 years, I have developed several very painful muscle spasms (I often refer to them as knots ) throughout my upper back and posterior shoulders. These spasms started small (just sore spots that weren t much of a concern), but over time they have become very large, to the extent that they now push on nerves (resulting in arm/hand nerve pain and numbness).  I frequently wake up in the morning with shin splints and/or aching muscles in one or more extremities (and I know that I did not do anything the day before to cause this pain--I just wake up with it).  Finally, I often feel very tired, even if I m sleeping well/enough. This is strange to me because I am very athletic/active (I do 60-90 minutes of intense cardio at the gym 7 days a week) and I am a very healthy eater.   I should also mention that my mother has Sjögren s Disease. My primary care doctor ordered blood work for me about 5 months ago and my ANA was normal. I ve been to Physical Therapy and it only made the muscle spasms worse. I ve tried Savella by my primary care doctor (for fibromyalgia), but was taken off of it due to side effects (I was an emotional basket case on it). I also REFUSE to take any kind of prescription pain medication (mainly because I feel that they would be a band-aid for a bigger problem).  Finally, i want to assure you that I am actually VERY pain tolerant. I don t let people know that I m in pain unless it is very severe. This IS severe--and it is absolutely diminishing my quality of life. I m only 28 and I wake up every day in pain, even though I maintain a very healthy lifestyle.   I don t know if you can offer ANY suggestions, but if you can, I would be extremely grateful. I apologize for bombarding you with information, but I did not want to omit any important information.  Thank you again for your time.