Approximately one in four people with diabetes may be affected by chronic neuropathic pain. Patients often present with discomfort, typically starting in the distal feet, but progressing proximally over time. Patients may describe symptoms of numbness, tingling, burning, aching, electric shocks, or lancinating pains .Other sites that are often affected include the legs, arms, hands, and fingers. The pain may be constant or intermittent and there may be associated nocturnal worsening. Patients may also experience allodia, when no painful stimuli are painful (commonly reported by patients when bed sheets become unbearably irritating), or hyperesthesia, when normally painful stimuli become excruciatingly