Have you been to a neurologist yet? And have you had a emg/nerve conduction test done? I think this test would help in determining your issue.
I have peripheral neuropathy and also lower back disc /arthritis issues. As you may be aware, the emg/ncs tests can detect large fiber neuropathy…however it typically can’t detect small fiber neuropathy (this can be detected via a skin punch biopsy). I also am pre-diabetic.
Best of luck.