<s>[INST] Hi my question is ive been experiencing for a few years now a variety of strange symptoms and they are as follows muscles aches mostly on the left side of the body as well numbness and tingling on my left arm and muscles twitching all over my body. Also a tension that runs down my left leg as well as pain at the top of my left foot left knee and left upper shoulder. And lastly at times full body numbness and dizziness. So my question is what do all these symptoms mean? ive been to my primary care doctor and he performed blood work for fibromyalgia as well as rheumatoid arthritis but everything comes out clear. [/INST] Hello, I passed carefully through your question and would explain that it is important performing a comprehensive differential diagnosis between different possible causes that may lead to this clinical situation: a bulging disc in the cervical column, vitamin D deficiency, fibromyalgia, etc. For this reason, I would recommend consulting with your attending physician for a physical exam and some tests: - a cervical spine X-ray study-complete blood count, PCR, ESR for inflammation- blood electrolytes for possible imbalance-vitamin D plasma levels.  A cervical spine MRI study may be needed, coupled with nerve conduction studies.  You should discuss with your doctor on the above tests.  Hope I have answered your query. Let me know if I can assist you further. </s>