Have bilateral peripheral neuropathy, etiology unknown, ruled out diabetes and neuro found spiinal pulses ok; male age 60, onset 8 yrs. Options?

Idiopathic. Many causes of neuropathy may not have a specific treatable cause. You may have a small fiber neuropathy that would need a biopsy for diagnosis. If there is pain involved then there are several meds that can help with symptoms. The best way to treat neuropathic symptoms us to treat the cause if the neuropathy. Makes it difficult if the cause cannot be determined.
Depends on the cause. Neuropathy is a condition resulting from abnormal nerve function. Neuropathy can be due to certain vitamin deficiencies, nerve damage due to trauma, alcohol consumption, radiation, side effects of certain medications, or due to certain medical conditions such as diabetes. Treatment varies depending on the cause of the problem. Have it evaluated and appropriately treated.
See below. It depends on the severety of the symptoms. If the pain is severe enough and progressing you might benefit from seein peripheral nerve speacialist at the university setting and possibly have a sural nerve biopsy.