"Microvascular" sounds familiar to me. I have another painful condition caused in some
way by microvascular problems, in my toes and forefeet. Because I have Polycythema Vera, I have thick blood, i.e. high red cells and platelets, which must clog the little vessels in my toes. The result, a painful condition called Erythromelalgia, with stabbing pain, burning pain and numbness. The numbness contributed to my fall in May, which broke my kneecap, which I have been recovering from for several months, now in an
Assisted Living for a month more. Now walking without a cane a little bit.

Since I also have MS and Porphyria dxs, I am used to having neuropathic problems, but never realized that they could be caused by vascular problems. This has become more familiar to me since my PV dx 5 years or so. I may need to take Interferon to lower the
counts.

The idea that neuropathy can be caused by vascular problems is now VERY familiar.

For years, I have taken a small amount of niacin (non flush) to control the paresthesias
in my temples and the fogginess in the eyes, which come on if I do not have niacin.

I don't know if niacin helps the erythromelalgia in my toes (numbness, pain). Not much,
it seems, but possibly this would be worse if I did not take the 250 mg of niacin a day.

I can't take the drugs which "control" neuropathy such as Lyrica. Sensitive to all of those.

I know of no means of operating on the microvascular structure in the toes--probably too small?