### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I have a numb left foot from about the ball of my foot to the end of my toes my right also has some numbness. I also have tingling and a sensation of heat on the tops of my feet more on the left and general painful aching. My legs have a feeling of being tired and aching pain and stiffness. I also have a numbness sensation in my legs I mean they don t feel numb exactly but if I scratch them for example I a numbness feeling , I don t feel the scratching to much. I have same aching in my arms not as much unless I do so lifting . I get numbness in my hands and fingers that comes and goes also sometimes I do something and I get a shock in my hands like I touched a electric fence. I have had a EMG done and Results I was told are normal same thing for aNCV I have had high CPK numbers only a couple hundred points high not taking any statins also had a high myoglobin number I think 100-200 points high. I am 44 yrs. male I had 2 level back fusion (s-1 l-4, l-5) about 5-6 yrs. ago no back problems since. Iam wondering if MS is something to look at and what tests might be done or what other possibilities I should think about. Thanks.

### output:

Hiwith history of spine disease, It's possible to have some naturopatChatDoctoruscular pains...if you aren't diabetic, then leg pains may be attributed to back. A check-up by orthopedics doctor for cervical (neck) spine may be necessary to rule out CS accounting for hand symptoms...MS is not so common cause, but a neurologist may decide for it by Ct/MRI head and spine if needed. A combination of gabapentin, methycobalamin, vitamin B1 B2 B6 B12 may also help if your doctor agrees...physical therapy in addition best wishes. Chat Doctor. 