Multifactorial or Idiopathic Neuropathy: This condition could explain the numbness in hands and feet without clear evidence of a specific cause, especially given normal labs and X-rays. It might be related to various factors including metabolic issues, vitamin deficiencies, or even early stages of diseases that haven't yet shown up in tests.

Cervical or Lumbar Spondylosis: Despite normal X-rays, early stages of spondylosis or soft tissue injuries not visible on X-ray could cause nerve compression leading to numbness and pain.
Fibromyalgia: A condition characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory, and mood issues. It could explain the back and neck pain, though the numbness might be less typical.
Peripheral Neuropathy: Could be due to various causes not yet identified by lab tests, such as early diabetes, vitamin B12 deficiency, or alcohol abuse.
Musculoskeletal Strain or Overuse: Repeated strain or overuse of muscles could lead to pain and potentially refer pain or numbness to hands and feet.

Multiple Sclerosis (MS): An autoimmune disease that affects the brain and spinal cord, leading to a wide range of neurological symptoms, including numbness and pain. Early stages might not show up on standard tests.
Spinal Cord Compression: Could be due to a tumor, abscess, or hematoma. Normal X-rays do not rule out soft tissue lesions.
Guillain-Barré Syndrome: A rare neurological disorder in which the body's immune system mistakenly attacks part of its peripheral nervous system, leading to numbness, weakness, and sometimes paralysis.
Cauda Equina Syndrome: A condition that occurs when the nerves in the spinal canal are compressed, leading to low back pain, numbness in the legs, and potentially bladder and bowel dysfunction.

Amyloidosis: A group of diseases that result from the abnormal deposition of amyloid (a particular type of protein) in various tissues of the body, which can lead to neuropathy among other symptoms.
Sjögren's Syndrome: An autoimmune disorder that can cause neuropathy among its wide range of symptoms.
Vasculitis: Inflammation of the blood vessels, which can lead to neuropathy if the vessels supplying nerves are affected.
Tumors (e.g., Neurofibromas, Schwannomas): Rarely, tumors along nerves can cause localized numbness and pain, though typically, these would be more focal than generalized hand and feet numbness.