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Taking Charge of Your Health


Small fiber neuropathy is really an interesting
condition because it consists typically of just burning, numbness, pain of the feet,
sometimes the hands later on without necessarily having any abnormalities on your EMG or nerve
conduction study. So what I tell patients and actually residents or students who train
under us is that a normal nerve conduction study does not exclude a neuropathy. And we
will confirm this by doing additional testing, specifically the nervous the the examination
at the bedside asking patients about their symptoms, for example, loss of sensation to
cool or or hot temperatures, loss of pain sensation and also doing skin biopsies where
we look at nerve densities in the skin both from the calf and the thigh as well as doing
a special test that looks at sweat function both in your foot in in the legs as well as
the feet to gauge the level of small fiber nerve damage. Small fiber neuropathy typically
will progress unless the underlying cause is identified and reversed. Diabetes of course
being the most common cause is always screened for. But once the more common causes are excluded
and the focus becomes on excluding any underlying secondary disease process but also controlling
pain because if patients’ symptoms of pain are generally controlled they tend to do pretty
well and really have no other major functional deficits. I’ve really become interested over
the years is how interconnected neurology and rheumatology are and one thing I often
do on patients who have unexplained small fiber even autonomic neuropathy is have them
see rheumatology or get evaluated for connective tissue disorders like lupus or Sjogren’s or
sarcoid and sometimes even if we are not directly involved in treating the patients, this can
be the first sign of an underlying connective tissue disorder that can then be brought to
the attention of rheumatology and addressed from their standpoint.

11 thoughts on “Small Fiber Neuropathy: Symptoms, Diagnosis and Treatment

  1. what does the sweat test show? I took the assessment on the wosag website and scored 75. I do have sarcoidosis. along with burning skin, I have sweats mostly on my legs n neck. difficulty eating food or digesting. always dizzy upon standing , severe flu like pain in arms n legs. back and scalp too. I haven't heard the scalp being part of sfn? so many symptoms make sense now. could humira be a cause of sfn or more likely just a part of sarcoidosis? thanks

  2. You're not doing a service to many patients whose SFN also causes Autonomic symptoms. Small nerves terminate into every major organ system and can commonly cause slowing and malfunction of the GI system just as one example. Also, even if pain is controlled, muscle will waste, making the patient weaker over time, less mobile, and in more pain. I do not understand why so many neurologists don't know about this. I had to find a neuromuscular specialist to help me understand what is happening. Thank you, though, for explaining the Skin Punch Biopsy. Believe it or not, many neurologists who haven't gotten around to offering this pretend it doesn't exist.

  3. Kudos for the video content! Sorry for chiming in, I am interested in your opinion. Have you considered – Taparton Sturdy Nerves Takeover (erm, check it on google should be there)? It is a smashing one off guide for getting rid of Peripheral Neuropathy and Diabetic Nerve Pain without the hard work. Ive heard some pretty good things about it and my mate finally got amazing results with it.

  4. So glad I discovered thisneuropathy treatment solution “gowo shocking plan” (G00GLE it) this! It helped my neuropathy pain in my foot. It was an excellent pain reliever after having foot surgical procedure! I also used it on foot as it was bruised and tender from the surgical treatment. The recovery of my foot was fast when I used it frequently. I`m not having much neuropathy pain now!

  5. This neuropathy treatment “gowo shocking plan” (G00GLE it) has worked for my sibling, and now, not only is she off the drugs, but her pain has been significantly reduced by at least 70%. I`m only happy to share her story to diabetic neuropathy sufferer. You`ll surely like this treatment solution. Search it now to learn more.

  6. Thanks deeply for sharing your thoughts…I really appreciate it!!! I have been battling Fibromyalgia and a Neurological disorder for many years and I am going to see a Neurologist very soon and I will tell him that I want a skin biopsy done!!! May Our Precious Creator of Life bless you greatly for helping to shed Light on this awful nerve problem!😇😄

  7. I`ve taken huge doses of different vitamins, used several homeopathic, and tried almost everything out there in my effort to cure my condition. I am only 34 years old, and needless to say, it has been a real battle. Nonetheless, I discovered this neuropathy treatment “gowo shocking plan” (G00GLE it) and was very curious about it. It is so easy that anyone can undertake it, and when done right the results can often be felt instantly.

  8. If either Sjogrens, Lupus, or Sarcoid is the underlying condition, is there a way to treat and reverse the neuropathy?

  9. I've been investigating reducing neuropathy quickly and discovered a great resource at Gabs Neuro Guide (google it if you're interested)

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