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Have MS, fibromyalgia, arthritis. Got cold hand, mottled skin. Suspected for thoracic outlet syndrome

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I have MS, fibromyalgia, arthritis. Two yrs ago my right arm became mottled and cold, at mid-bicep region, but it is not present all the time. My hand is so cold sometimes that I have to wear a glove to bed. This arm and hand are bigger than the left. Now I am getting the mottling on my legs, and my right knee is purple. Saw a rheumatologist, dermatologist, neurologist, internist - no one knows what the problem is. It even gets cold and mottled in the summer. Besides being embarrassing I would like to know what is going on. I have been told that I have thoracic outlet syndrome but a vascular surgeon said I didn't. Could it be from an injury - like regional pain dystrophy. I severely injured my knee 2 yrs ago and it is still swollen. All blood tests are negative for other auto immune diseases, ultrasound was negative.
Posted Thu, 18 Apr 2013 in Multiple Sclerosis
Answered by Dr. Raju A.T 3 hours later

Thanks for your query.

Functions like temperature regulation and sensation, pigment production by the melanocytes, blood vessel diameter alterations etc are carried out by impulses through peripheral nerves.

If there is any sort of damage to those nerves or defect in conduction, symptoms like abnormal temperature sensations, defective blood circulation leading to cold, purple extremities, mottling due to improper melanin stimulation etc can occur.

Such peripheral nerve damages are commonly seen in conditions like Multiple sclerosis. I believe that the symptoms you have are secondary to nerve damage that occurs in MS.

Treatment with medications like Pregabalin which improve the nerve health will help to get rid of such symptoms. Do discuss about the same with your neurologist.

Hope I answered your query.

Please let me know if there are any other concerns.

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