The only thing I can add to this discussion is my own personal journey, and maybe there will be some clues that help others.
I'm in my 30s, and was active (plant nursery worker, retail, nanny) for all of my 20s. 2 years ago, I got a 100% remote desk job. My numbness in my feet and hands (onset by my first COVID infection, Fed. 2020) got progressively worse, and then the pain started. In 2022, I was diagnosed with peripheral neuropathy. I've already been on celecoxib for my Lyme's joint inflammation since 2018, but I had shingles last Nov. (2024) and was prescribed gabapentin for the first time. My foot pain went away! Oh wow, I was so grateful.
The only issue is: for me, the side effects of gabapentin were intolerable. I'm a writer and I lost my mental sharpness. The night sweats, lack of REM sleep, and mood instability drove me nuts as well. So I went off of it and the nerve pain in my feet came back. Then, while researching at-home treatments for my chronic bloating issues, I came across the idea of "hourglass syndrome" where if for years, like me, you've sucked in your upper stomach (because of the stupid societal pressure to have a flat stomach) leading to torso weakness, muscle atrophy and more of the lower abdominals, etc. Apparently there's a cascade effect that happens when you do this long enough! Muscle, ligaments, GI system, etc.
So I googled the appropriate physical therapy PDF exercises and did them every day for a couple of weeks. Guess what happened? My peripheral neuropathy/nerve pain in my feet went from a 6-8 out of 10, to a daily maybe 1-4!
All I can figure is that some nerves of mine (especially at the hip and sacrum) have been chronically pinched from my desk job, and the nerves became damaged/weak from all the infections too, so that doing these PT exercises "flossed" the nerves, bringing back blood flow, and, for lack of better word life to my nervous system!
I still use CBD/G/N gummies occasionally now, and I'm still on my Celebrex 1x daily for my joint inflammation from Lyme's (different system), but when I step on the ground anymore, I don't wince from the broken glass stabbing--because it's just not there anymore! For those who made it to the bottom of this: consider, with your doc, if maybe some of the nerves issues can be soothed through mechanical (exercises) vs. chemical (meds) means! Who knows.
You are the first person I have come across who has peripheral neuropathy as well. Actually my diagnosis is poly peripheral neuropathy. Initially I thought as I imagine you did too that just the feet and hands were the problem. I use Lyrica which works fine. I refuse to use gabapentin as my 2nd husband died from a complication of it. Then both of my arms and both my legs failed leaving me on the floor for 18 hours. When the feeling came back I called for help. This was a whole new animal. I don’t know when it can happen again. Sometimes it’s only one arm or one leg. On January 22nd all four limbs failed. Again. This time the feeling came right back. I have a very green but wonderful DO for a primary care doc who just doesn’t get the seriousness of my situation and is dragging her feet on a neurology consult. Does this happen to anyone else. I feel quite alone in his situation.