Unexplained Leg and Arm Symptoms: What Could It Be? - Internal Medicine

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The symptoms you are experiencing in your left calf and forearm, characterized by a cool sensation and subsequent aching when at rest, can be quite perplexing. Given that you have already undergone blood tests that returned normal results and ruled out rheumatic conditions, it is important to consider other potential causes for your symptoms.

One possibility is that you may be experiencing peripheral neuropathy, which is a condition that affects the peripheral nerves and can lead to sensations such as tingling, numbness, or a "cool" feeling in the limbs. Peripheral neuropathy can be caused by a variety of factors, including diabetes, vitamin deficiencies (especially B vitamins), alcohol use, or even certain medications. Since you mentioned that this sensation has been present for many years but has recently worsened, it may be worth investigating whether there are any underlying metabolic or nutritional issues contributing to your symptoms.

Another potential cause could be related to vascular issues. Conditions such as peripheral artery disease (PAD) can lead to reduced blood flow to the limbs, resulting in sensations of coldness or discomfort, especially during periods of inactivity. Although your blood tests may not have indicated any immediate vascular problems, it might be beneficial to undergo further vascular assessments, such as an ultrasound or an angiogram, to evaluate blood flow in your legs and arms.

Additionally, your symptoms could be indicative of a condition known as complex regional pain syndrome (CRPS), particularly if there is a history of injury or trauma to the affected areas. CRPS can manifest as persistent pain, changes in skin temperature, and altered sensations in the affected limb. It is often accompanied by a heightened response to stimuli, which may explain your urge to rub or massage the area.

Given the complexity of your symptoms, it would be advisable to consult with a neurologist, who specializes in conditions affecting the nervous system, or a vascular specialist, who can assess for any circulatory issues. A thorough clinical examination, along with additional diagnostic tests such as nerve conduction studies or imaging studies, may be necessary to arrive at a definitive diagnosis.

In the meantime, managing your symptoms may involve lifestyle modifications, such as regular movement and stretching to improve circulation, as well as avoiding prolonged periods of inactivity. Physical therapy may also be beneficial in addressing any underlying musculoskeletal issues that could be contributing to your discomfort.

In summary, while your symptoms may initially seem benign, they warrant further investigation to rule out potential neurological or vascular conditions. Consulting with the appropriate specialists will help you gain a clearer understanding of your symptoms and guide you toward effective treatment options.