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[QUOTE=slick50;4620194]Thanks for the information. I'm wondering how this might be diagnosed and possibly treated.[/QUOTE]

The symptoms you describe are typical for various forms of neuralgia, neuritis, neuropathy - all terms that mean something in your nervous system is causing the symptoms. The nervous system is broken up into two sections - the central nervous system (brain, cranial nerves, and spinal column) and the peripheral nervous system (all nerve branches that bring nerve impulses between the spinal cord and the rest of the body.) Most nerve problems are diagnosed primarily by a thorough neurological exam, and this is particularly true for peripheral neuropathies. Each nerve bundle that exits the spine serves a particular region of the body (called a dermatome.) By careful sensory testing, the neurologist is usually able to determine which dermatomes are affected, and this helps narrow down the nerves likely to be responsible for your discomfort.

When neurological symptoms are present in multiple areas of the body (involving multiple dermatomes,) the neurologist has to consider the possibility that the symptoms are caused by problems in the central nervous system or by systemic diseases (MS, Lyme Disease, ALS, lupus, etc.) that may attack nerves or otherwise affect nerve function. Certain Vitamin deficiencies can also cause widespread nerve discomfort, so numerous tests are often necessary to diagnose the exact (or most likely) cause of your symptoms. Blood tests, immunoassays, and imaging studies (CTs and MRIs being the most common) are standard diagnostic tools for neuropathic problems. Unfortunately, the results are often inconclusive, so in many cases, your diagnosis will be made on the basis of excluding other less likely diagnoses. This is an imprecise method, but is all too often the best that doctors can offer.

Neurological diagnostic tools have improved drastically in the past decade or two, but medical science is still in it's infancy regarding neurological diseases and syndromes. Be prepared to endure a lot of testing, and don't be surprised if you have to repeat the same tests over and over for many of the doctors you meet, and you may have to see several doctors before you find one who is able to diagnose and/or treat you effectively. Try not to give up hope, and be as concise as possible when describing your symptoms. Be prepared to advocate for your own care, as there are still too many doctors all too ready to lump you into a diagnosis based on only some of your symptoms (the ones they understand or believe.) Be prepared to hear doctors contradict one another, saying things like "It can't be {diagnosis X} because your symptoms don't fit." If a diagnosis is elusive, you still deserve symptomatic relief.

Treatment options for neurological problems have increased in the past decade, mirroring the advances in diagnostic tools. Without knowing the cause of your symptoms, it's really difficult to guess what the appropriate therapies might include. Nerve compression may be the culprit, in which case surgical decompression MAY be possible. Other physical problems, like Chiari malformations or bulging discs, may also respond to surgery, but only a neurosurgeon is qualified to give you likely outcomes. Many drug therapies are also available and likely to help, but you may have to try several before finding one that works without excessive side effects.

If you get nowhere with your neurologist, seek a second or third opinion, and consider seeing a pain doctor in an integrative, multidisciplinary pain clinic. Through personal experience and in conversations with many other neuralgia sufferers, it seems that pain specialists in such clinics provide optimum care for the whole patient. I wish you the best.

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