Greetings @peggioh, welcome to Connect. It looks like you are reaching out for information that will help with the symptoms of SFN. I also realize that Naltrexone has shown some encouragement for folks with pain and fatigue. Are those symptoms you have experienced with SFN? Have you had relief from the dosage you are currently taking?

On another note....would you mind letting me know how your SFN was diagnosed? Did you have a single-skin punch biopsy? If so do you recall your "score"? Mine was .09 which isn't comfortably strong. I was diagnosed in 2013 or 2014. Since then I have explored multiple treatments and medication options.

Amitriptyline was my first nighttime medication and it sure helped. I also tried Gabapentin in the morning but my body reacted with dizziness. So I have moved 600 mg of Gabapentin to night-time to help keep my hands from having tingle tangles and numbness. And over the last four years, I have been using Duloxetine (Cymbalta) in the mornings to reduce my anxiety. As you know anxiety creates pain and then the pain turns right around and creates more anxiety. I am grateful to Duloxetine for making my days calmer and therefore less painful.

My days always have some exercise activities.....everything from stretch Yoga, to balance and stability training and of course, my frequent 2-mile river walks when the weather isn't unwelcoming.

Have you been able to keep your body moving? Does that help with your discomfort?
What activities do you enjoy?

And finally, my pain control has been through the courtesy of medical cannabis which I have been learning about and experimenting with for 10 years. You have to become your own prescriber unless you can receive pharmaceutical assistance at a dispensary.

I almost forgot about my experience with mindfulness practice and meditation. It takes some practice. However, when you can have private and meaningful chats with yourself, then you have an opportunity to focus on self-compassion and well-being.

Does any of this sound doable to you?

May you be free of suffering and the causes of suffering.
Chr