@dckuke Some studies showed some systemic effect from Qutenza, but that may be in exceptional cases. It is formulated so that even though much stronger than over-the-counter capsaicin ointments it is actually considerably less irritating in most cases as well as far more effective. Additionally, it has to be used for at least a year to have significant effect. I hope the CBD balms continue to give you some benefit. Magnetic therapy is another possible option being used at VA hospitals, etc. Yet another is carboxytherapy and, eventually, I hope, topical pirenzepine, which may be approved in Europe, estimated 2028. Qutenza and pirenzepine are the only drugs that have so far shown any ability to have benefit with regard to the underlying causes of most peripheral neuropathies, whatever the etiology. Everything else merely addresses some symptoms and very imperfectly at that.