Emg study for puffy feet reads . a fairly symmetric mild sensorimotor peripheral neuropathy with primarily axonal loss features. what are options?

It depends: The first thing would be to address possible underlying causes such as diabetes. There are medication which can help to minimize any symptoms of the neuropathy.

Look for causes: There are a number of things that can cause this type of neuropathy, and the next step would be to look for treatable causes, such as diabetes, thyroid disease, or vitamin deficiency.

If truly axonal: We can classify neuropathies based on the type of pathology. If an actual axonal neuropathy, the causes are far fewer than the schwann cell category. Could be diabetic, alcohol-nutritional, porphyria, solvent exposure, amyloid, paraneoplastic. Sometimes difficult to pin down fully at first, but therapy may be directed based on cause. Discuss with your doctor.