What is the diagnosis for a 42-year-old female patient with polyarthralgia (pain in multiple joints), particularly in the knees and feet, exacerbated by walking, with a history of slightly elevated blood glucose (hyperglycemia) and relief with rubbing and myofascial release, resulting in numbness?

Fibromyalgia: This condition is characterized by widespread musculoskeletal pain, fatigue, and tender points. The patient's description of pain in most joints, worsening pain with activity, and the sensation of a "paper cut" in her skin are consistent with fibromyalgia. The relief from rubbing and myofascial release followed by numbness also supports this diagnosis.

Osteoarthritis: Given the patient's age and symptoms of joint pain, especially in the knees and feet, osteoarthritis is a plausible diagnosis. The pain worsening with walking and improving with rest is typical for osteoarthritis.
Diabetic Neuropathy: Although the patient's metabolic panel was mostly unremarkable, the slightly elevated blood glucose could indicate early diabetes or prediabetes. Diabetic neuropathy can cause pain, numbness, and tingling in the feet and other areas, which aligns with some of the patient's symptoms.
Rheumatoid Arthritis: This autoimmune disorder can cause widespread joint pain and stiffness, particularly in the hands and feet. However, the absence of morning stiffness and other systemic symptoms makes this diagnosis less likely.

Lyme Disease: This bacterial infection can cause widespread joint pain and other systemic symptoms. It's essential to consider Lyme disease, especially if the patient has been exposed to ticks, as missing this diagnosis can lead to severe consequences.
Multiple Myeloma: This type of blood cancer can cause bone pain, which might be perceived as joint pain. Although rare, missing this diagnosis can be fatal, making it crucial to rule out, especially with unexplained bone pain.
Hypothyroidism: This condition can cause widespread musculoskeletal pain, among other symptoms. While the metabolic panel was mostly unremarkable, thyroid function tests were not mentioned, making hypothyroidism a "do not miss" diagnosis.

Ehlers-Danlos Syndrome: This group of genetic disorders affects the body's connective tissue and can cause joint hypermobility and pain. The patient's symptoms of widespread joint pain and the unique sensation of pain could be related to this condition, although it is rare.
Sjögren's Syndrome: This autoimmune disorder can cause joint pain and neuropathic symptoms. While less common, it should be considered in the differential diagnosis, especially if other systemic symptoms are present.