Peripheral Neuropathy Quiz Step 1 of 5 20% Are your feet ever overly sensitive to touch?*YesNoAre you unable to sense your feet when you walk?*NoYesWhen you get into the bathtub or shower, are your feet unable to tell the hot water from the cold water?*YesNo Do you ever feel weak when you walk?*YesNoIs the skin on your feet so dry that it cracks open?*NoYesAt night, in bed, does it hurt when the covers touch your skin?*NoYes Have you experienced an asleep feeling or loss of sensation in your legs or feet?*NoYesDo your legs and/or feet ever feel numb?*NoYesDo your legs and/or feet ever feel numb?*NoYes Do your legs and/or feet hurt when you walk?*NoYesAre your symptoms worse at particular time of the day?*Yes, during the dayNoYes, at nightDo you ever experience a sharp, stabbing, shooting pain in your feet or legs?*NoYes Do you ever experience a prickling or tingling sensation in your legs or feet?*NoYesDo you ever experience muscle cramps in your legs and/or feet?*YesNoHave you ever experience an electric shock-like pain in your feet or legs?*NoYesCommentsThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.