If you have symptoms of burning or tingling in your legs or have been diagnosed with any of the following: diabetic neuropathy, alcohol induced neuropathy, any nerve damage induced neuropathy, or fibromyalgia, you may have Small Nerve Fiber neuropathy (SNF). Neuropathy is defined as a collection of disorders that occur when nerves or the peripheral nervous system (the part of the nervous system outside of the brain and spinal cord) are damaged. It is estimated that there are at least 20 million Americans suffering from some form of Small Fiber Neuropathy. The most common causes of SNF neuropathy are diabetes, pre-diabetes, and metabolic syndrome. Studies have also shown that up to 50% of patients with Fibromyalgia suffer from SNF neuropathy. SNF is also associated with amyloidosis, HIV infection, connective tissue disorders and pharmacological neurotoxicity. In many cases, however, and especially in the elderly, no specific cause is found.
Symptoms include pain within the skin, sensory loss and dysfunction of autonomic functions such as heart rate, control of perspiration and digestion, which can lead to impairment. Some patients only have pain, which can be very difficult to quantify and very sensitive and specific testing is required in making a correct diagnosis. Nerve conduction tests such as Nerve Conduction Velocity and EMGs aren’t able to detect SNF because the nerves involved are very small caliber nerves that have very slow conduction and therefore cannot be found with these conventional tests. A method, which involves small biopsies of skin, allows us to determine microscopically if there is any damage to these small epidermal nerve fibers.
Many treatments are available for SNF neuropathy. The most effective ones address the cause of the neuropathy such as getting your diabetes under control, or improving your nutrition. Physical therapy can be very effective in improving your muscle tone and deconditioning. The important part of this is that your treatment is tailored to you and what your specific needs are.
Alpine Pain and Rehab Solutions of Utah have partnered with Nova Labs in California to provide the diagnostic testing needed to determine if you have SNF neuropathy. The biopsies needed are very small and the area of the skin is anesthetized (numbed) prior to the biopsy. The skin biopsies are a safe procedure with minimal discomfort that allows the physician to correctly diagnose the disease. If you would like to find out more, you can schedule a consultation with one of our providers.