Diagnostic Challenges of Small Fiber Neuropathy

If you are suffering from chronic nerve pain that doesn’t seem to respond to pain management treatments such as nerve blocks or steroid injections, you may be suffering from a condition called small fiber neuropathy (SFN). This condition results from damage to small nerve fibers found throughout the body and can be hard to diagnose when patients also have orthopedic conditions such as herniated or bulging discs. For those with damage to the small fibers in the skin or peripheral nerves, individuals may experience burning and shooting pain, numbness, and increased sensitivity to pain, typically beginning in the feet and progressing upwards. Others with damage to the fibers in their internal organs may experience disturbances to the body’s self-regulated functions such as digestion, blood pressure, and heart rate. While ⅓ of cases are initially idiopathic, the most common precursors are diabetes, pre-diabetes, autoimmune disease, or cancer.

Traditional blood tests are currently limited in their ability to diagnose SFN cases. However, since neurological symptoms have an earlier onset, a neurologist trained in small-fiber neuropathy can provide a timely diagnosis through a skin biopsy, which measures small nerve fiber density. At Hudson Medical, we offer in-office skin biopsies and research-backed treatments such as intravenous immunoglobulin therapy to optimize patient outcomes.