Small fiber sensory neuropathy is a neuromuscular disorder that affects millions of people. It can be caused by various conditions, such as diabetes or prediabetes. It can also occur on its own. Main symptoms are tingling in the feet, numbing of the skin’s ability to feel temperature, inability to feel pain, or pain signals randomly sent even when there is no trigger. Therefore, it can be challenging to get a small fiber sensory neuropathy diagnosis. Treatment for small fiber sensory neuropathy can also be challenging.
What Are the Causes of Small Fiber Sensory Neuropathy?
Small fiber sensory neuropathy happens when the small fibers of the peripheral nervous system are damaged.
The peripheral nervous system is not located in the brain or spine. The nerves that make up this system carry pain, temperature, and other information to the brain or spine. They control digestion, blood pressure, and heart rate, and connect your brain and spine to your muscles.
When any of your peripheral nerves are damaged, they are able to regrow. However, there is some damage that requires intervention or surgery to heal.
Small fiber neuropathy or small fiber sensory neuropathy affects the sensory nerves. It also affects the sweat glands, gastrointestinal system, blood vessels, and heart.
What Are the Symptoms of Small Fiber Neuropathy?
Symptoms of small fiber neuropathy include:
- Pain and burning sensation in the feet, trunk, or arms
- Electric-shock level pain randomly throughout the day
- Cramps
- Lightheadedness
- Blood pressure drops when sitting or standing up
- Loss of consciousness
- Sweating
- Gastrointestinal issues
- Sexual difficulties
- Heaviness in feet or hands
- Paralysis
- Bladder issues
The pain caused by small fiber sensory neuropathy varies throughout the day. Usually, it is worse in the evening or at night. You may even feel pain just from the sensation of your bedsheets touching your feet.
How is Small Fiber Neuropathy Diagnosed?
Small fiber neuropathy can often be misdiagnosed or misunderstood. Symptoms are numerous and vary, and the condition can show up in combination with other diseases. Additionally, many tests that look at the nervous system do not pick up on the sensory nerves in the same way that they do with other nerves.
Some of the conditions that can cause small fiber neuropathy are:
- Fabry’s disease
- Wilson’s disease
- Diabetes
- Glucose intolerance
- Vitamin B12 deficiency
- Thyroid dysfunction
- HIV
- Lyme disease
- Hepatitis C
- Alcohol
- Chemotherapy
- Neurotoxic drugs
- Vaccine consequences
- Fibromyalgia
- Sarcoidosis
- Rheumatic disease
- Lupus
- Connective tissue disease
In order to diagnose and treat your small fiber neuropathy, it may be necessary to first determine whether or not you have any of the associated conditions. You may also need to meet with various doctors and specialists, give them your medical history, and perhaps have a physical examination. However, the most crucial test for determining whether or not your sensory nerves are healthy is a skin biopsy test.
A skin biopsy is a procedure in which your doctor will collect two small samples of your skin. These will usually be taken from your ankle and your hip joint. Your doctor will then look at samples and test the density of your sensory nerve fiber. The accuracy of the test is relatively high and has been found to be 90% effective.
The biopsy sites will be wrapped up and dressed. You will be able to take the dressing off within seven days of your skin biopsy. You shouldn’t feel pain during or after the procedure.
What Is the Treatment for Small Fiber Neuropathy?
Because there are so many causes of small fiber sensory neuropathy, there are many ways to treat it. For example, you may be told to stop taking a particular medication or given instructions to manage your diabetes. Managing pain may be the treatment your doctor recommends.