I have severe bilateral neuropathic pain in my lower leg and feet. i have it during the day, but it's horrific at night. i also have shooting pain?

Diabetic?: Are you diabetic? Treatment for this can be gabapentin or lyrica (pregabalin). It could also be secondary to back issues. Good luck!

Are you treating it?: I'd recommend: 1) don't let it get worse. You need to stop the progression. If it is caused by diabetes, keep sugars controlled. If nerve compression you might need surgery. Other causes need evaluation. 2) some meds can lessen the symptoms, e.g. gabapentin, amitriptyline, pregabalin, duloxetine and others. See a neurologist to evaluate and treat this condition.

The cause?: An EMG may help what kind of neuropathy you may have (radiculopathy, plexopathy, peripheral neuropathy, tarsal tunnel syndrome, etc). Blood work may help pin down the cause of a peripheral neuropathy. Sometimes the cause may be a small fiber neuropathy which is diagnoses by nerve biopsy.

Best approaches: First, you need to uncover cause, and one is always present, just may be elusive. Second, drugs such as gabapentin, Lyrica, (pregabalin) Cymbalta, if tolerated and at effective dose can blunt the pain. Third, a medical food called MetanX may help over several months. Fourth, might try Voltaren gel over feet, but Ketamine cremes may also work well.