Small fiber neuropathy?

Posted by Nemo1 @nemo1, Feb 16 9:00pm

I never had a biopsy to dx it. I’m wondering if I have the biopsy does it make a difference in the therapies? A year ago I was dx’d with severe chronic nerve damage in lumbar and cspine: polyradiculopathy.

I have severe pain and spasms in lumbosacral back, legs and feet since 2021.

In the summer of 2023 I started (an continue having) get spasms in the trapezeous muscles on the right.

I’m currently flaring with bad pains to both shoulder that is crippling then after a long while it disappears. I developed lightning like pains to the bottoms of my feet and toes. The only thing that seemingly helps the surface pain is the lidocaine cream I apply. So far…

The neuromuscular doctor said last year no long fiber neuropathy per the nerve conduction study. She said I’d need a biopsy to determine if i have sfn.

An old nerve doctor said I had demyelination in left leg she thought secondary to diabetes. WEll, the diabetes hasnt climbed to damaging enough numbers to put me in flair much less cause the demyelination.

The foot dr last week gave referral for feet, for neuropathy and balance. So this confuses me. It all does.

I’d like to know if SNF can move around the body and cause the tingling in forarms and fingers and can the pain in SNF affect the very surface of the skin?

If someone can make sense of what Ive written I’d appreciate any help insight or feedback.

I have not received a diagnosis regarding the polyradiculopathy. I’m going to press the doctors for answers now because it’s really out of control.

Interested in more discussions like this? Go to the Neuropathy Support Group.

@poulterjazzy

Thanks for sharing your story again; it’s really helpful to hear others’ experiences. Bookmarking is a great idea—I’ve started doing that too for threads like this. Small fiber neuropathy can be so challenging, especially with mobility issues. Have you found any strategies or treatments that have helped manage your symptoms?

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Hi @poulterjazzy, Welcome to Connect. You might also like to scan through this older discussion to learn what others have shared on their neuropathy journey.

-- Member Neuropathy Journey Stories: What's Yours?
https://connect.mayoclinic.org/discussion/member-neuoropathy-journey-stories-whats-yours/
Also the Connect search function is really helpful when searching for others with specific words or phrases in mind. Here's a search using "neuropathy +what helps" - https://connect.mayoclinic.org/search/?search=neuropathy+%2Bwhat+helps

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Please try Deep Myofascial Tissue Release Therapy (there is a section in this forum - MFR), acupuncture, yoga, light persistent stretching. deep breathing technique; keep the house warm, epson salt baths/rubs and aroma therapies. Keep walking through the pain, and stretch before and after. Try inflammatory relief supplements one at a time. learn if your condition is exacerbated by the weather. (mine is!) Go to a good orthopedic surgeon and find out if any nerve roots exiting your spine are being impinged because of disc or vertebrae problems. (start at the "root" causes first) Eliminate radiculopathy being misdiagnosed as neuropathy. My go-to pain relief is diclofenac 3%, muscle rub (salicylic acid/menthol type) and lidocaine 5%. Good luck!

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@dbeshears1

My mobility is caused by weakness primarily. In 2016, I was stricken over a 10 day period by severe increasing leg/arm weakness accompanied by a UTI & kidney infection. On the 10th day and finally in a hospital, my knees finally buckled and I remained in a wheelchair for 6 months with extensive physical therapy that made great gains in strengthening my legs and getting balance to where I can waddle around unassisted for small distances now; but I cannot climb, do small steps or even a curb without help or a cane/walker. I cannot run, skip, or hop, but am grateful for what I can do and for being out of a wheelchair & able to drive. My hands are limited but I can now handle forks & knifes & TP!

In the hospital they tested for Guillain-Barre but it came back inconclusive because they did not obtain enough spinal fluid to test. They didn't retest because the hospital facility itself was not so specialized for neurological issues. I later went to Duke who says it's a possible I had post-infection disorder similar to GBS but there would be no treatment available for it regardless. So we're not exactly sure, but I have been tested for a lot of things that have been eliminated. I am officially labeled as Idiopathic Axonal Sensorimotor Peripheral Neuropathy, but I have never been tested for SFN. My symptoms seem to overlap both though: extreme sensitivity of hands & feet to cold (and heat); numbness & tingling from elbows to fingers, knees to toes; inability to sweat properly in heat; and general balance & weakness issues. My PN comes with a bit of pain that is managed well with Gabapentin.

So that was the long answer to the causes of my mobility issue. I spent a lot of time trying to get an exact cause so I could get an exact cure. My number one priority now is to keep strong with activity and physical therapy so I do not get worse and can live the best life possible!

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Have you had a small fiber biopsy? NIH has a good continuing education paper on SFN that came out last year. Look it up under the PubMed site. Lots of current info.

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@suetex

Have you had a small fiber biopsy? NIH has a good continuing education paper on SFN that came out last year. Look it up under the PubMed site. Lots of current info.

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No, None of my doctors over the years have felt that it would add value to my current diagnosis since they know I have axonal sensory PN. One said I couldn't also have SFN, but that has been disputed by people on here that know they have both. Regardless, the doctors have all said there is nothing they can do but help manage the symptoms, so I learn to live with it from the wealth of information and real life experience with PN on this forum!

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@dbeshears1

No, None of my doctors over the years have felt that it would add value to my current diagnosis since they know I have axonal sensory PN. One said I couldn't also have SFN, but that has been disputed by people on here that know they have both. Regardless, the doctors have all said there is nothing they can do but help manage the symptoms, so I learn to live with it from the wealth of information and real life experience with PN on this forum!

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There is a lot of new info about this condition and one of its causes, Sjogren's. And you can have SFN for a time and then it effects the long nerves. You may be able to still lessen your symptoms. Worth learning about. (BTW: I have this, too.)

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@suetex

There is a lot of new info about this condition and one of its causes, Sjogren's. And you can have SFN for a time and then it effects the long nerves. You may be able to still lessen your symptoms. Worth learning about. (BTW: I have this, too.)

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Thanks so much for the information!

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