@fala My neurologist skipped the EMG and went right to the skin biopsy because he said if the EMG was inconclusive, we’d need to do the biopsy anyway. The biopsy was not painful, other than a slight poke of the needle to numb the area. Prior to visiting this doctor, I had no idea about SFN so it was worth it for me to get answers and begin to explore treatments/medication. To your point, you know you have it so why proceed with the EMG? Do you have other symptoms? Are there other underlying conditions they think need to be explored that can’t be pursued without positive test results? Sometimes insurance won’t cover certain tests or medication without other cause. That’s the only thing I can think of. I went through a bunch of tests after the positive SFN to look for an underlying cause. Nothing was found so they can only treat my symptoms, but if they were to find an underlying cause, sometimes treating that can help the neuropathy.