Am I insane? I have pain and I feel like I’m going numb.
No, you are not insane because you have pain and numbness. Peripheral neuropathy, when it is damage to the ends of the nerves, can pick and choose which nerve endings to damage.
Your symptoms depend on which nerve endings are damaged.
Think of your peripheral nerves. They have a main cell body coming right off of the spinal cord. Inside they have many individual nerve fibers, like a coaxial cable is made up of many individual wires twined together.
Eventually these individual nerve “wires” end. Some end up and make a muscle fiber fire. Some make you cry like when you read your phone bill. Some tell your glands to squirt hormones into your bloodstream. And some tell you how soft the puppy’s ear that you are petting is.
The ends of the nerves are specialized and basically have one job each. One job! So if a bunch of the nerves for feeling warmth are damaged, you will have a tough time feeling warmth. If they really get damaged they can send the sensation of heat when they are not supposed to.
Here is a chart from https://www.dartmouth.edu/~rswenson/NeuroSci/figures/Table_1.htm with some more detail on the individual nerve endings and what they do.
So whichever nerve endings the neuropathy decides to damage gives you your symptoms. Look at the chart above. The second group from the top does touch sensation. If they are damaged, you get numb-ish. The bottom group does burning pain. If they are damaged, he or she gets a burning type pain. If both groups are damaged, then that patient has both numbness and burning pain.
And that’s just the sensory nerves. There are also motor nerves, previous blog, that you use for movement and balance.