What is Small Fiber Neuropathy. Why This is Necessary For Fibromyalgia

Welcome! It looks like you might be new here, so I wanted to take a moment to tell you a little about me and my blog. My name is Julie Ryan and I live with Fibromyalgia. I’ve chosen to live positively, to fight back with diet and lifestyle changes and it’s made a huge difference for me. The difference between living all my days in bed, and actually LIVING. I hope you’ll keep reading – check out the sidebar for a list of my readers favorite posts, and ..n the last few years we’ve seen many articles about the overlap of small fiber neuropathy (or small fiber polyneuropathy – same thing) in Fibromyalgia and the hope that we may be able to use skin biopsies of these small fiber nerves to diagnose Fibromyalgia. I’ll be honest I thought for a while we were just seeing the same study popping back up in the news (and it frustrated me); however, I’ve realized I was wrong. There have actually been a couple of studies in as many years that have made this connection. That said all of the studies I’ve read have been very small (less than 30 participants), and they are not finding that all of the Fibromyalgia patients have this (only about 50% of those in the studies). However, these studies may be a stepping stone to uncovering one potential cause for the pain associated with Fibromyalgia.

But, what is Small Fiber Neuropathy?

Small Fiber Polyneuropathy (SFPN) is a disease (yes, an actual disease) that cause degeneration in the small fiber neurons. The small fiber nerves are the ones that transmit the information about pain and temperature. These small fibers are also involved in many areas of the autonomic nervous system (the part that controls the automatic features like breathing, digestion, blood flow), so it’s a little more than just burning and itching in the feet.

Unlike problems in the large nerves small fiber neuropathies don’t show up in EMG and nerve conduction studies. SFPN is most commonly associated with diabetes, but can be caused by a variety of other diseases and illnesses, and can even be genetic. A skin biopsy is the primary way of diagnosing SFPN. Unfortunately, diagnosis of SFPN doesn’t do much for those of us with Fibromyalgia except perhaps make us feel like we have a better diagnosis than just Fibromyalgia. The treatments for SFPN are basically the same ones that we already use for Fibromyalgia (anti-depressants, anti-convulsants, topical pain treatments, gabapentin, and tramadol to name a few.

What are the symptoms of Small Fiber Neuropathy?
  • Painful burning/ itching feeling in the hands and feet – this seemsto be the primary symptom
    • Often worse at night and/or made worse with heat or cold – often people can’t stand to have the sheets touching their feet.
    • Alcohol can also increase this symptom
  • Digestive symptoms including diarrhea, constipation, nausea, vomiting
  • Urinary incontinence
  • Periods of increased heartbeat
  • Dry eyes/ mouth
  • Abnormal sweating
  • orthostatic hypotension
  • erectile dysfunction
  • Skin changes in affected areas

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