@ww2valentine I'm not sure if your question was directed to me. You can ask your rehab therapist about the pattern of muscle atrophy and weakness that you have, and if that matches what your imgaging and reports say about your stenosis and any nerve compression that you have. There can be multiple reasons for symptoms that overlap, so there may not just be one answer. Spine surgeons have to assess that as a "differential diagnosis" because they need to know if their surgery could help. If they do surgery, it may not fix a problem if there are multiple causes, and the surgery is to decompress something like a nerve or the spinal cord. From my own experience with muscle atrophy in my arms and shoulders, it was only after decompression surgery that my muscles began to recover and rebuild in physical therapy, and that takes a long time as the nerves heal. I don't have diabetes, and I don't know how much that will affect nerve function. It is possible that rehab is a test to see if you will improve before any spine surgery is considered. Often medical notes that state surgery is recommended also state that physical rehab had failed to improve the patient. I had central canal cervical stenosis with spinal cord compression, and physical therapy helped by realigning my spine and took a little bit of pressure off. The muscle spasms were pulling the normal neck curve out of alignment and twisting or turning the vertebrae and effectively making the spinal canal smaller. It was a temporary fix until the next spasms occurred. They also used electrical stimulation to calm the production of neurotransmitters which actually carry the pain impulses between nerve cells across the synapse (gap) between them.

Your rash should be evaluated, and it may not be related to diabetes. I know that shingles produces a rash that follows nerve pathways and is very painful. My mom had it, and she had dark red bumps in a line. Nerve pains can be burning, stabbing and like an electric shock. I have not had shingles myself. It's easy to assume something is related to something else, and make a mistake and go without treatment. A medical professional can intercept a problem before it gets serious, but only if they have a chance to evaluate it. I have made this mistake myself thinking I was having my normal allergy sinus problems, and in reality there was an infection in the root of a tooth causing the pain, and damaging jaw bone. I didn't recognize the problem until it had gone pretty far and then an oral surgeon cleaned out the infection and replaced the lost bone.

You might be interested in our Myofascial Release discussion. You can have compression of nerves and tissues from fascial tightness, and MFR therapy can help that if it is a physical problem. This helps neuropathy for some patients and there is mention of it in the neuropathy discussions here. Here is the link. https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/