@adriggs MS or even ALS is something that is considered as a differential diagnosis for a spine problem. Have you ever had an injury to your spine or a whiplash? Have your doctors done imaging on your spine to look for potential problems? The thing about a spine injury is that years later, arthritic changes happen, discs collapse, etc, and you may not know that a problem had been brewing there for years. It took twenty years for this to happen to me after a whiplash. Another possibility after a whiplash is developing TOS or thoracic outlet syndrome. I have that too, and it does cause chest tightness and that's enough to start twisting ribs and causing chest pain in the costal cartilages and near the sternum. When I get a spasm it starts in my neck and goes down to my chest and that can be confused for heart related which I did have checked out. I also know that when I can use my hands to massage and stop the chest pain that it is a muscle spasm and I also massage the neck muscle that started it all. I'm not suggesting patients diagnose themselves, but this was the answer after heart issues were ruled out.

I am a Mayo spine surgery patient and I had a compressed spinal cord in my neck caused by a ruptured disc and bone spurs. That was generating pain all over my body and for a while, and that pain would change location depending on which way I turned my head. I have also had instances of cold sensitivity caused by nerve issues. The first time was due to a spinal injection that caused a lot of new pain with electric shocks and as that gradually subsided, I was left with cold sensitivity in my hand and that lasted a year and a half. My spine surgery was 4 years ago and I am well recovered. This past spring, I had a bad ankle fracture which was causing nerve pain all during the time I had a cast, and after my cast was removed, it got better slowly, but I had the sensation of stepping into cold water with my injured foot. I was barefoot and looked at the floor to see if there was water there, but there was not, so that too was a nerve still recovering from an insult. If there is any possibility of a neck or back injury from an accident, you may want to ask for spine imaging. MS can show up on a brain MRI, and on my spine imaging, there was enough of the brain stem that the neurologist could say that I did not have MS. Unfortunately this type of spinal cord issue that causes all over pain is difficult to get diagnosed, and surgeons didn't connect that to my spinal stenosis until I got to Mayo for my 6th opinion. I could have saved myself a couple years if I had come there first. It's called "funicular" or "referred pain" when spinal cord compression causes these symptoms. I also had nerve conduction and EMG testing and had some normal results except for muscles that had atrophied because of the spine problem. Keep track of any changes over time. I was drawing my nerve pain on a body diagram and dating it so I could tell how it was progressing as my bone spurs grew bigger. My spine surgery resolved all of that.