My neuropathy is hereditary and I had symptoms of poor coordination, odd gait, and clumsiness since childhood. Numbness started in my toes in my early 30's. Real muscle weakness was becoming a problem in my late 40's, but I had been unusually strong for a woman, I am 6'2", and large boned. Now at 53 I cannot move my toes, can barely move my ankles, have lost a lot of strength in my hands and arms, all this corroborated by physical therapy.

It has been a slow process, for me the axons have died off, which eventually affects the muscles and circulation. My skin biopsy shows NO small nerve fibers in the feet and lower legs and a deteriorating process even at hip level. This is in addition to large fiber neuropathy which weakens the muscles. If PN causes muscle atrophy it is normally a slow process. Tendonitis can do it overnight as I found out in the past since I also have a history of pinched nerves which flare up sometimes. My hands and arms are useless then.

I have no feeling below my knees, no temperature, needles, nothing.

As to pain, I had mild pain for years which I attributed to varicose veins. It started to get worse in my mid 40's, with standing and going up steps becoming a problem. Then sharp shooting pains in my legs together with the burning, electrical zap, and feelings of furry things running around on me. Now the pain is quite severe and controlled by medication enough for me to be somewhat active and able to sleep.

I would think sudden muscle weakness was an indicator of a different problem.