Brief Answer:
Cool sensation in the back

Detailed Answer:

Hi,

When an alteration of feeling or temperature is reported in a part of the body one of the first things we as neurologists think about is that a nerve or nerves are behaving out of the ordinary since they should not be sending signals to the brain of such a "cool sensation" in the back...if in fact, there is not something actually physically that sense organelle in the skin to be activated. In other words, if there were a breeze blowing on your back because you had the window open and it were cold or cool outside then, we can understand that. If someone with cold hands coming out of a cooler or freezer at work comes to you and places their hand on your back and you report feeling this as cool or cold..again, we understand that......If you were a football coach in the NFL such as our beloved XXXXXXX BROWNS....and they were to WIN just 1 game over the course of last season.....you might get freezing cold GATORADE poured on your back at the end of the game! We definitely understand that.....BTW, just in case you're not a football aficionado...the XXXXXXX BROWNS went the entire season in 2017 without a win... :(

Therefore, for all those examples.....there's a reason that explains the sensation....but in the case of a nerve or group of nerves that are firing that COLD or COOL sensations are being detected when in fact, no reason for that temperature gradient exists....then, that's abnormal and we would refer to that as a NEUROPATHY involving some dermatomal or radicular region. Things that can cause that type of a picture would be things that bother nerves such as compression, pinching, trauma, or metabolic problems that affect how they work. Metabolic causes include things such as diabetes mellitus, endocrinological problems such as thyroid disease, adrenal disease, or pituitary dysfunction. And still another possible cause would be anything that causes DEMYELINATION or loss of the integrity of the covering of a nerve itself which could either originate in the brain..or spinal cord over a certain course of a dermatome or 2..or it could involve an entire region.

Some rheumatological disorders such as FIBROMYALGIA and MYOFASCITIS have been described by patients as presenting with sensations of coldness (in the back area). This could be another avenue of investigation depending on the rest of your history and symptoms you may have.

In order to decide FIRST on the notion of whether or not this is even a NEUROPATHY you would need to be examined by a neurologist and a thorough history and physical done looking for other subtle abnormalities of nerve function should be conducted. If the physical examination is unrevealing then, the neurologist should get to the work of sending you for blood and even urine tests as I've outlined above searching for evidence of metabolic, hormonal, or infectious dysfunction and then, they may even send you for imaging studies of the brain or the spinal cord of the area of concern such as MRI's or CT scans. I doubt that something such as an electrical study (EMG/NCV) would be of any benefit in your case. Nor would I consider things such as spinal taps, EEG's, nor autonomic function studies at this stage of evolution since your symptoms don't point in any of those directions.

If after thorough workup and physical/lab testing everything comes out clearly then, I might consider the possibility of anxiety and stress since one of the most common symptoms people relate when having acute symptoms such as yours without any physical cause relate to diagnoses of generalized anxiety and stress disorder. Perhaps, something of an extremely burdensome nature just occurred within the past few weeks and you've not been able to easily get around the problem or figure how to fix things. All of those concerns and worries could manifest as sensations of cold or coolness...and the back is no an uncommon location to feel it....just think of how you feel when you get a "SHIVER DOWN THE SPINE..." usually happens in the setting of an emotional episode or occurrence, right? So too may this be very similar, except in your case the feelings are lasting longer.

Hope I have answered your query.

Regards,
Dr. Dariush Saghafi, Neurologist

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