Reply @jhumm sorry to hear about your situation which is somewhat similar to mine. Although my Small fiber neuropathy is also labelled as "ideopethic" I suspect ciprofloxacin antibiotics to be the culprit in my case. I have severe pain and numbness at the bottom of my feet with numerous other issues similar to what you have described. I have tried all kind of therapies and remedies but to no avail. I suggest you become member of a facebook group called "Fluoroquinolones Toxicity ", which I am sure can give you additional ideas based on experiences of that group. Since we are labelled as "ideopethic " we need to explore all avenues that are available. I wish you a speedy and permanent relief.