Your burning feet are not a foot problem. They are a metabolic emergency.

Your feet burn at night. Even the bedsheet feels like fire. That is a cellular alarm. The small vessels feeding the nerve are starving it of oxygen, and high blood sugar is damaging it from the inside.

The standard answer is a pill that turns down the volume. Gabapentin, pregabalin and duloxetine do one thing: they quiet the alarm. They do not restore blood flow, stop glycation or rebuild myelin. So patients climb to maximum doses, foggy, tired and unsteady, and still wake with their feet on fire. The alarm keeps ringing because the emergency is still happening.

Regenerve treats the emergency. It is a single-physician practice by design: Dr. Gurpreet Singh Padda, MD, MBA, MHP, its physician owner and medical director, performs the evaluation, reads the nerve and vascular testing and writes the plan. His background is on his page. Unsure this is your clinic? Tap the directory assistant (the light in the corner of the page).

Why do my feet burn with neuropathy?

Diabetic nerve pain is not one disease. It is three failures in the terrain around the nerve, often at once.

1. Starving micro-vessels

Every foot nerve is fed by vessels thinner than a hair, the vasa nervorum. Diabetes thickens, stiffens and closes them. The nerve downstream starves. A starving nerve fires: burning, hot coals, fire under the sheets. It is worst at night, when circulation to the feet naturally drops.

2. Sugar caramelizing the wiring

Glucose that stays high bonds to nerve proteins and fats and forms advanced glycation end-products. It is the browning reaction that caramelizes sugar in a pan, running inside you every day sugar is uncontrolled. The products stiffen vessels, inflame tissue and injure fibers directly.

3. Insulation breaking down

Myelin wraps each nerve. When it degrades, signals distort, then stop. Numbness. Wooden blocks. Wet sand. Poor balance.

Numbness is not improvement. It is the signal failing.

What else causes neuropathy?

Blood sugar is rarely the only driver. Gluten sensitivity can inflame nerves even when a celiac test is negative. Alcohol, certain medications, heavy metals, autoimmune disease and hidden nutrient deficiencies add to the load. Infection and trauma cause it too. A plan aimed at one driver misses the rest.

How is neuropathy diagnosed at Regenerve?

Measured, not assumed.

• EMG and nerve conduction studies, on site. Conduction studies measure how fast and how strongly a signal travels. Needle EMG records the muscle that nerve supplies. Together they localize the damage and separate a compressed or entrapped nerve from a metabolic neuropathy. That distinction changes the plan. Large-fiber testing can be normal in small-fiber neuropathy, so results are read with your history and exam.
• Circulation and small-fiber testing. Ankle cuffs measure blood flow to the feet while surface electrodes record nerve response.
• VNG balance testing. Videonystagmography measures the inner ear's balance organs. Neuropathy is not always the only reason a person is unsteady, and the answer decides what balance work targets.

Before any of that, you can take the free Nerve Damage Score: five large-print questions, about two minutes, with the result emailed to you. It names which of the three failures is most likely driving your symptoms.

What treatments does Regenerve use?

Every plan follows a physician evaluation. The plan works three fronts: restore microvascular perfusion so oxygen reaches the nerve, shut down the pathways producing glycation damage, and supply the substrates nerves need to rebuild.

Nerve substrates at clinical doses

• Benfotiamine, fat-soluble vitamin B1. It activates transketolase and diverts excess glucose away from the pathways that make glycation and oxidative damage.
• Alpha-lipoic acid, an antioxidant working in water- and fat-based tissue, quenching the free radicals glycation and ischemia produce.
• Methylcobalamin, active B12, the raw material for myelin repair. A "normal" B12 blood test can hide nerve tissue that is functionally deficient.

These are physician-guided clinical doses, not an over-the-counter product.

Qutenza, the 8 percent capsaicin patch

FDA-approved for neuropathic pain from diabetic peripheral neuropathy of the feet. A clinician applies it in the office. It is never dispensed for home use and is not repeated more often than every three months. It overstimulates, then reversibly switches off, the TRPV1 pain receptors on small skin fibers, reducing their signaling for weeks to months. It is roughly a hundred times more concentrated than drugstore creams. Its established benefit is pain relief, not proven nerve regrowth.

The NS100: 20 days, nothing left behind

An FDA-cleared Class II programmable peripheral electrical nerve stimulator for painful diabetic neuropathy. Four small electrode arrays are placed at the ear in a roughly 30-minute office procedure under topical anesthesia. They sit on the auricular branches, so the device acts as a vagal stimulator. They stay for a 20-day course and come out at a follow-up visit. No battery, generator or hardware stays in your body.

Peripheral nerve stimulation for chronic intractable pain is a Medicare-covered category, and the NS100 is billed as a Class II peripheral nerve stimulator. Your coverage still depends on your plan and documented medical necessity. Benefits are verified before scheduling, and an authorization is not by itself a guarantee of payment.

Orthobiologic injections (PRP and BMAC)

Prepared from your own blood or marrow and delivered under image guidance, offered in selected situations. The position is stated in two sentences of equal weight. No reliable ability to regenerate nerve, reverse neuropathy or consistently prevent progression has been established. Within the options available, these injections help symptoms: easing pain and numbness and improving day-to-day function.

For peripheral nerve repair the evidence comes from preclinical models and small clinical series rather than large randomized trials, and these therapies are not FDA-approved specifically for peripheral neuropathy. Plans generally do not cover them. They are offered only inside a physician-directed plan, never as a guaranteed therapy.

Light and heat

• Class 4 photobiomodulation, high-power laser targeting cytochrome c oxidase, the enzyme driving mitochondrial energy in injured nerve tissue, and supporting circulation through the vasa nervorum.
• Class 3B cold laser, a gentler, focal dose for localized nerve pain.
• Whole-body infrared on a dedicated table, for circulation and reduced muscle guarding, often before rehabilitation or a procedure.

Other advanced therapies listed by the clinic

• Exosome-based nerve regrowth therapy
• Peripheral nerve stimulation
• Cannabinoid-based therapies
• Closed-loop neuromodulation that adjusts stimulation in real time
• Palmitoylethanolamide (PEA) and C-15 lipid supplementation
• Endoscopic nerve decompression for compressed nerves
• Insulin and glutathione infusion therapies
• Mitochondrial support, from B vitamins, alpha-lipoic acid and CoQ10 to SS-31 (elamipretide), an investigational mitochondria-targeted peptide that is not an FDA-approved neuropathy treatment

Support

Remote patient monitoring, telehealth follow-ups, lifestyle and behavioral coaching, physical therapy and rehabilitation, nutritional counseling, wound care for neuropathy-related wounds, and balance and gait training.

Why does the order matter?

You cannot rebuild a nerve that is still being starved and glycated every day. That is building on sand. The sequence:

1. Correct the terrain. Blood sugar, glycation, micronutrients, circulation, inflammatory drivers, mechanical contributors. Stop the ongoing injury.
2. Calm the overfiring fibers, for example with the capsaicin patch, to open a window of reduced pain.
3. Deliver repair signals and restore mitochondrial energy, so the nerve has instructions and fuel during that window.

The practice calls the goal metabolic sovereignty: a nerve cannot heal in a hostile environment.

How long does treatment take?

Peripheral nerves repair at about a millimeter a day, at best. Many patients notice improvements within weeks, but repair itself is a months-long process. Results vary with how advanced the loss is at the start. The earlier the terrain is corrected, the more nerve there is to save.

What do patients say?

Four patients shared their words, with written permission:

• "I couldn't walk to the mailbox without unbearable pain. After just a few weeks of treatment, I'm hiking again." Sarah M., 62
• "The burning in my feet kept me awake night after night. Now, I sleep peacefully and wake up energized." James T., 58
• "Peripheral neuropathy had forced me to quit my job I loved. Now I'm pain-free, confident, and making money again helping my family." Maria L., 47
• "After years of failed treatments, I thought I'd never find relief." Robert K., 78

Individual results vary.

What happens at a visit?

1. Take the Nerve Damage Score, if you like.
2. Physician evaluation and diagnostics confirm the pattern and rule contributing causes in or out.
3. A plan built on your specific drivers.
4. Follow-up to track progress, because nerve repairs slowly.

No referral is needed. Existing prescriptions are never changed on your own, only in coordination with your physician.

Does insurance cover it?

Coverage varies by plan and by which parts of care are involved. The driver named in your chart matters: a record that says only "neuropathy" is harder to cover than one that names the cause. In-clinic light therapies fall under office-based therapy benefits, so ask your plan which category applies. Fees are not published on the website; they are discussed directly with the practice during planning, and the clinic offers flexible financing.

Where is Regenerve?

Regenerve, Advanced Peripheral Neuropathy Treatment Center, 4477 Woodson Rd, Suite 104, St. Louis, MO 63134. Next to Lambert International Airport, with on-site parking and easy access from I-70, I-170 and I-270. Open Monday through Friday. Call or text (314) 886-5902.

It serves St. Louis City and County and every community within 20 miles of the airport, including Florissant, Hazelwood, Bridgeton, Maryland Heights, St. Charles, St. Peters, Clayton, University City and Kirkwood, and the Illinois Metro East.

Regenerve is one of the clinics on pain and metabolic medicine in St. Louis.

Frequently asked questions

Can peripheral neuropathy be cured?

A cure is not always possible. Treatment can dramatically reduce or eliminate symptoms and restore quality of life, and where loss is advanced the priority becomes halting progression and protecting remaining function.

Should I stop gabapentin?

No. Never stop a prescribed medication on your own. These drugs can control pain while the terrain is corrected, and any change is made with your physician.

Why can't I just treat the pain?

Because masking the pain while the nerve is still starved and glycated lets the damage keep going. The nerve dies back from the toes up while the prescription holds the symptom down.

Who is a candidate?

Most people with neuropathy, whether newly diagnosed or struggling for years. The evaluation decides which therapies fit your drivers.

Why does Regenerve treat Illinois patients?

Dr. Padda is licensed in Illinois and holds full staff privileges at Anderson Hospital in Maryville, so patients from Maryville, Edwardsville, Glen Carbon, Collinsville and Troy are treated here instead of being referred back across the river.