What medication works best for mechanical foot neuropathy pain?

@corneliagd, Late 70s female here. I was diagnosed with ideopathic peripheral neuropathy in 2021 although the symptoms existed for several years prior to that. I was having the same night-time issues you mention - burning, tingling pain in my feet and legs and the need to constantly move my legs. My doctor prescribed gabapentin and I take 500 mg an hour or so before I'm ready to go to bed. It definitely has helped me get a good night's sleep but when it wears off it's like a switch is flipped and the symptoms return. I only take the gabapentin at night as I found it makes me drowsy during the day. However, when I'm up and moving around during the day, the symptoms are not as noticeable - other than the sensation that I'm walking on marshmallows. That makes me very careful about making sure I'm stable when I stand up, in particular.

@corneliagd, You will notice that we changed the title of your discussion to better describe your question so members with similar symptoms can share their experience. I did find some research that talks about managing the symptoms of the condition that might be helpful:

"Appropriate pharmacological management
The appropriate use of pharmacological agents can assist the effective management of mechanical foot pain, although specific drug trials are lacking. To ensure the safe and effective use of medication, relevant prescribing guidelines, such as the Therapeutic Guidelines and national evidence-based formularies, need to be consulted [126]. Short-term relief of symptoms can be achieved using paracetamol and NSAIDs [127]. Most cases of mechanical foot pain are superficial, and topical NSAIDs are preferred over oral NSAIDs owing to their better safety profile [128]. For localized mechanical foot pain that is difficult to manage, CS injections can provide short-term pain relief (≤6 weeks) [129–132]. Although IA hyaluronan injections and autologous growth factor injections might be exciting alternative pharmacological approaches for OA and for tendon and plantar fascia pathology, respectively, their effectiveness has not been established in rigorous randomized trials [133–135]. Opioids have limited benefits and significant risks of harm, hence their use is limited to recalcitrant pain, with close monitoring [126]."
-- Current and future advances in practice: mechanical foot pain: https://pmc.ncbi.nlm.nih.gov/articles/PMC10712443/

The article also has other other ways that can help manage the symptoms including Lifestyle and education strategies, Mechanical strategies (orthotics) and Therapeutic exercise.

I have tried 8 hr Tylenol and it helps sometimes. Back in March of 2025, I started working out at 125 Live and my feet started cramping more. My daughter suggested I try "BodyAmour" Sport drink--water with electrolytes. It is cheaper in one liter sizes than the 700 ml sizes and you can get it in six packs. Body Amour solved two problems for me: stopped the cramping and helps with dehydration.

@rollingf, I'm glad to hear the sports drink is working for you. The only problem I have with Body Armor and other sports drinks is that they have a lot of Vitamin B6 in them which can make neuropathy much worse if you drink too much of the drinks.