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Small Fiber Neuropathy

Medically reviewed by Last updated on Aug 31, 2022.

What is small fiber neuropathy?

Small fiber neuropathy (SFN) is a condition that affects certain nerves in your body. These nerves help you have senses such as touch and pain. These nerves also help control functions such as blood pressure, digestion, and body temperature. SFN can happen with other forms of neuropathy.

What increases my risk for SFN?

  • Genetics
  • Conditions such as diabetes, celiac disease, or sarcoidosis
  • Being older than 65 years
  • Drinking too much alcohol and poor nutrition
  • Certain medicines and toxins such as chemotherapy and arsenic

What are the signs and symptoms of SFN?

Symptoms usually begin in adolescence or early adulthood. Severe pain attacks usually begin in your hands and feet. As you get older, the pain attacks happen in other areas of your body. The pain attacks are usually worse at night or while you are resting. You may also have any of the following:

  • Stabbing or burning feeling in your fingers or toes
  • Tingling, numbness, or itching feeling in your fingers or toes
  • Not able to feel a pin prick
  • Cannot feel the difference between hot and cold
  • Urinary and bowel problems
  • Dry eyes or mouth and decreased sweating
  • A drop in blood pressure when you stand up

How is SFN diagnosed?

Your healthcare provider will ask you about your symptoms. He or she may do a skin biopsy. During a skin biopsy, a small piece of skin is removed and sent to the lab for tests. Your healthcare provider may remove skin from more than one area. Your healthcare provider may also recommend nerve testing. Nerve testing measures changes in blood pressure, heart rate, and sweating.

How is SFN treated?

Treatment depends on the cause. If SFN is caused by diabetes or prediabetes, the treatment will include getting your blood sugar levels under control. Treatment may also include medicine such as antiseizure, antidepressant, or pain medicines to treat symptoms.

Treatment options

The following list of medications are in some way related to or used in the treatment of this condition.

How can I manage my symptoms?

  • Manage health conditions that lead to SFN, such as diabetes, sarcoidosis, and HIV.
  • Lose weight. Ask your healthcare provider what you should weigh. If you need to lose weight, ask him or her to help you with a weight loss program.
  • Exercise regularly. Talk to your healthcare provider about exercise. Ask him or her how many days in a week, and for how long you should exercise. Exercise can help with weight loss and lower your risk for diabetes complications.
  • Limit alcohol. Alcohol affects your blood sugar level and can make it harder to manage your diabetes. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor.

When should I contact my healthcare provider?

  • Your symptoms get worse.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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