Lets assume that you have “aching’ that is coming from small blood vessel spasm, at least in part. This small blood vessel spasm could be “neurovascular” in origin with a nerve going to a small blood vessel (magnified by the millions of small blood vessels in actuality) that undergoes spasm, thereby limiting blood flow to the tissue (eg, muscle, tendon, other soft tissue, bone….etc) and thereby causing limitation of blood flow to the tissue. Patients with diabetes have “neurovascular causes” of their severe foot pain. One treatment efficacious for the neurovascular pain of diabetes that MIGHT be worthwhile trying is Benfotiamine, a fat soluble derivative of thiamine. Benfotiamine was synthesized in Germany ~60 years ago and has been shown in randomized control trials to treat the very painful peripheral neuropathy of some patients with diabetes and this neurovascular complication. Benfotiamine MIGHT be worthwhile trying at a dose of 300 mg (it comes in 150 mg caps) twice a day for a total daily dose of 600 mg. Benfotiamine as studied by the Germans and so far confirmed in US clinical trials has no known side effect though like even placebos “side effects” have been reported by individual patients. Consider identifying a reputable source and consider a trial of this over the counter agent. It works by facilitating the movement of thiamine into the inside of the cell (lining blood vessels and neurons). Inside the cell it is converted into a “cofactor” of an enzyme called Transketolase. Transketolase acts (via use of its cofactors thiamine pyrophosphate and magnesium) to shunt otherwise destructive glucose metabolites into productive versus non-productive pathways. So, a “non-productive pathway” could be: glucose metabolite –> oxidtive stress –> endothelial dysfunction –> microvascular dysfunction –> regional blood flow abnormality (eg restriction of blood flow to a muscle or group of muslces) –> “downstream pathologies” as diabetic painful peripheral neuropathy, severe unexplained muscle cramps, restless legs, gastroparesis, some forms of sleep apnea, kidney dysfunction, retinopathy, microvascular angina (especially in women as per Mayo Clinic Journal review article). Look up “Benfotiamine” in pubmed for more info on the latest possible therapeutic possibilities of Benfotiamine. By the way Benfotiamine does not in humans cross the blood brain barrier – another thiamine derivative synthesized in Japan, Allithiamine – Allicin + Thiamine found naturally in garlic does cross the blood brain barrier. Some individuals with unknown causes of pain can benefit by taking Benfotiamine that does negate the “non-productive pathway” above. Worth a potential “self-trial” after you do a thorough analysis of pubmed articles on Benfotiamine.