Brief Answer: Need work up and management to confirm the cause Detailed Answer: Thank you XXXX I am Dr S Khan and i would like to answer your query for painful cold extremities and their numbness and cyanosis. Miss XXXXXXX i want you to know that these presentations are masked by many diseases from compressive neuropathies,Nutritional neuropathies, Alcoholism, Systemic illnesses and vasospastic conditions. 1-Compressive neuropathies like spondylosis, nerve compressions, Nerve outlet syndromes etc can cause this. 2-Vasospastic Conditions- In which vascular structure gets in spasm due to mild exposure to cold, Exaggerated sympathetic responses like Raynaurd's phenomenon and frostbite which are very common. 3- Alcoholism leading to neuropathies like wernicke syndrome , direct alcoholic neuropathy, Poor dietary and vitamin supplementation specially thiamine can result in this. 4- Systemic- It can be a systemic illness and manifestation like some vasculitis, kidney disorders, liver disease, vascular damage and blood diseases, amyloidosis, connective tissue disorders and chronic inflammation, hormonal imbalances (including hypothyroidism), and cancers and benign tumors that impinge on nerves. 5-Nutritional Neuropathies: Metabolic derangements like diabetic neuropathies are very common. Simple vitamins like B12 B6 B1 and Niacin deficiency can also cause this. In Nut shell what presentation you have is masked by many etiologies and no online consult would be enough to help. You would need some work up to sort it out under observation of a competent neurologist and Endovascular surgeons if needed. Hope it helps.Take care miss XXXXXXX and don't forget to close the discussion please. Regards S Khan

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