Idiopathic Small Fiber Neuropathy - chest pressure/tighteness

Good morning @sf2021, Good for you. You are using good questions and following up on the information. Anxiety was my enemy and caused a lot of SFN pain.....until......I had a psychobehavioral series of tests that found my anxiety to be way too high and a big contributor to pain. I substituted 60 mg of duloxetine (Cymbalta) for 600mg of gabapentin and added some morning tincture.

Two weeks ago, we added 30mg more of duloxetine and dropped another 300 mg of gabapentin. It has been a week and my body is finally adjusting and I am seeing how this might work. We have to have patience, be willing to have a shared decision-making relationship with your primary who can help you keep it all together.

Here is the link to the MFR therapy.
https://myofascialrelease.com/

May you be safe, protected, and free.
Chris

I have SFN and found this bit of news interesting. I have had dull, aching pain around the bottom of my rib cage when I have been in an upright position too long. A heating pad and being in my recliner are helpful. I also have celiac disease which, along with SFN, can cause SOB. My cardiologist kept saying my SOB was not heart related but no one could give me another explanation. I had a lung study done and I came out fine. Another dx I have is median arcuate ligament syndrome which plays games with my diaphragm and possibly rib cage.

Barbbie, interesting observations about your symptoms, their possible relationship and your pursuit for answers. In the Digestive Health group, there is an active discussion with several members discussing median arcuate ligament syndrome (MALS) and supporting one another. You may wish to join them here:

- Median Arcuate Ligament Syndrome (MALS) https://connect.mayoclinic.org/discussion/median-arcuate-ligament-syndrome-mals/

Good morning, I'm late in joining this discussion, but I find it very interesting. I was very recently diagnosed with SFN, and while I do have some peripheral issues, mine are mostly autonomic. For more than a year, I've had intermittent dull to very sharp pain under my left breast very near the sternum. I've even gone to the ER a few times certain that I was having a heart attack. I've had multiple heart workups with no significant findings. I've always had asthma, and it's been suggested that it's an allergic or panic reaction, neither of which make sense in the context. Sometimes it just aches and others it's so sharp that it takes my breath away. Now that you mention it, I also wonder if this was one of the early signs of my SFN (?SFMAD). My neurologist keeps telling me that SFN can cause such a wide range of symptoms that almost anything is possible. Any other thoughts, experience or info that anyone has would be greatly appreciated.

Hello @jealge1, Welcome to Mayo Clinic Connect, a welcoming online community where patients and caregivers share their experiences, find support and exchange information with others. I think it's really important to ask questions and learn as much as you can about your health conditions which is what you are doing now. There is another discussion that you might want to read through and meet other members discussing autonomic neuropathy.

Autonomic Neuropathy: https://connect.mayoclinic.org/discussion/autonomic/ - There is also an older discussion with the same name that you might want to read and learn what has been shared - https://connect.mayoclinic.org/discussion/autonomic-neuroapthy/

Here is one of my favorite resources for information on neuropathy research and other related information that you might find helpful.
-- Neuropathy Commons: https://neuropathycommons.org/

Are you able to share your biggest challenge or concern with your autonomic neuropathy?

I get a pain and severe tightness in the chest if I am around animals. Everyone including my doctor says aha, asthma is the problem. I agree I have asthma which causes me to cough, however to me asthma is not the answer to chest pain so acute it can be debilitating for several weeks after exposure to an animal. I should add that I am not afraid of dogs or cats and in my prior to asthma days owned several animals. I just love dogs and cats so I don’t think the problem is fear or anxiety caused also had a complete heart assessment and was found to be in good heart health.. Anyone out there have experienced this type of chest pain, I would love to hear from you.
Willows

Hi @willows I do not have asthma but my daughter developed it during her childhood. She is now in her late 20’s and gets the tightness although she loves cats and dogs. She went to an allergist and discovered that she was allergic to pet dander on top of her asthma. Every time she visited me she had to take an allergy pill because of our pets. It didn’t stop her from owning a cat. She now has a dog. After seeing the allergist for 2 years, her allergy level significantly decreased. Perhaps seeing an allergist will help with your symptoms. Initially she did have to go through a series of tests for the doctor to custom make a medication she received. As time went on she needed it less often to suppress her immune response. She had no problems when receiving the covid vaccination. Hope this helps. Toni

Just joined the group. I was diagnosed with small fiber neuropathy at Duke this past march after having the symptoms for 12 years. I've had sporadic chest pain along with leg numbness and pain for many years. My pain is in the area of my sternum which is often very tender to touch. I also have sporadic stomach discomfort with my neuropathy. I've had an equivocal diagnosis of pericarditis in the past but the 6 or so echocardiograms I've had over the years have essentially been normal. It's clear now that the chest pain is nerve related. Since March, I've taken 300 to 900 mg. of Gabapentin per day depending on the level of my symptoms. It definitely seems to take the edge off. Otherwise, ibuprofen seems to help somewhat as do the anti-inflammatory properties of raw ginger. I have good days and bad days and occasionally go a few weeks feeling fairly well and then the leg symptoms and chest pain return with a vengeance. I am a 56 yr old male and also have had CLL for 6 years. I'm otherwise healthy and try to exercise as much as possible.

Hello @tedtheus, Welcome to Connect, an online community where patients and caregivers share their experiences, find support and exchange information with others. I have idiopathic small fiber peripheral neuropathy but only have some numbness in my feet and a little above my ankles. There is another discussion you may want to read through where members including myself have shared their neuropathy journey.

Member Neuropathy Journey Stories: What's Yours?: https://connect.mayoclinic.org/discussion/member-neuoropathy-journey-stories-whats-yours/

I think we can all relate to having the good days and the bad days. It's helped me to just take them one day at a time and do the best that I can. Exercise really helps me too and I also try to do as much as I can. Have you tried to figure out if there may be something that triggers the bad days?

John, thanks for the reply. So far, I've not been able to figure out the triggers for the bad days or weeks. Glad to have joined the group.