--a small-fiber neuropathy, possibly ischemic in nature (associated with fluctuations in blood pressure/blood flow to the extremities), and/or influenced by biomechanical compressive forces (the "double crush" hypothesis, which implies that multiple negative forces on peripheral nerve can produce symptoms that are more than the sum of their parts, and which would not otherwise be anywhere near as noticable).

It seems like you need a good work-up from a neuropathy specialist, which would include a lot more blood work (and probably a multi-hour glucose tolerance test, which mught be far more accurate at determining glucose dysregulation/insulin resistance than a fasting blood test of hemoglobin H1Ac--it is now well established that small-fiber neuropathy can happen with impaired glucose tolerance well in advance of a diagnosis of frank diabetes) and probably some nerve conduction tests. A caveat, though--small-fiber (the fibers that subsume the sensations of pain and temperature) problems cannot be ascertained through standard nerve conduction studies, which can only measure the transmission of fairly large, myelinated nerves.

Some good places to check out protocols:

The Liza Jane spreadhseets:

www.lizajane.org

This Quest application paper:

http://www.questdiagnostics.com/hcp/...eralNeurop.htm

The Poncelet protocols:

http://www.aafp.org/afp/980215ap/poncelet.html