A 58-year-old man presents to the clinic with a 6-month history of burning and pricking pain in both feet. He describes the pain as feeling like he is “walking on hot coals” and notes it is often worse at night, interfering with his sleep. He also reports progressive numbness in his toes. His medical history is significant for type 2 diabetes mellitus diagnosed 10 years ago, hypertension, and obesity. His current medications include metformin, lisinopril, and atorvastatin. He works as a warehouse manager but notes his pain is increasingly causing him to miss shifts. He drinks alcohol socially and does not smoke. He appears uncomfortable, frequently shifting his feet in his chair. His blood pressure is 135/85 mmHg with a heart rate of 78 bpm, and he is afebrile.