I’ve found it can help a little with inflammation which can decrease pain some but it is just something to use in conjunction with other things

When I first started suffering with small fiber polyneuropathy 8 years ago, I didn’t know why I had widespread pain ( wasn’t diagnosed yet), but I couldn’t start my day until I soaked in an Epsom salts bubble bath. The Dr Teal’s products are what I used. It soothed my painful muscles and helped me start my day. The thought of my usual morning shower was unappealing because I woke up in so much pain. Even though I was strong and fit, I had trouble getting out of the tub. I did this for a long time while being worked up for various illnesses, which seven painful years later was finally diagnosed as SFN. So yes, hot water with Epsom salts is very soothing, and in my experience temporarily decreases pain!

I soak my feet nightly in hot water mixed with an Epsom salt bath. But my little tub has a vibrating feature I use as well while soaking.
It is all about 20 to 30 minutes.
Some relief and mostly calming down from the stress it feels.
.Next, I use infrared light. Those are shoes like Contraption I stick my feet in for 20 minutes and finally before bedtime rub my feet with BIOFREEZE cream. Cheapest at Walmart.
It keeps the pain away until morning.
The numbness however is always there.