Spotlight on Small Fiber Neuropathy

Small fiber Neuropathy is a disorder of the small, sensory cutaneous nerves characterized by severe pain attacks starting in the feet. Here DrBonnie360 deep dives into the details and intricacies of this condition, and delineates therapeutic options and supportive patient communities to help you conquer your own health journey.

Written by: Bonnie Feldman, DDS, MBA, Anna Simon, BS

Autoimmune disease is an “invisible epidemic.” Despite this, it affects roughly 16% of the US population. Yet, autoimmunity remains under-recognized, under-researched, and under-served. Because of that, we at Your Autoimmunity Connection are publishing a series of “spotlights” on autoimmune diseases or other diseases that are closely linked to immune dysfunction. We aim to combat this lack of awareness and to connect patients, families, and caregivers with useful resources.

First and foremost, our new spotlight shines on small fiber neuropathy. Continue reading to become connected with available statistics, research initiatives, supportive patient communities, and more! Nonetheless, don’t forget to check out our Facebook page and forum for more autoimmune-related updates.

What is small fiber neuropathy?

Small fiber neuropathy is a form of peripheral neuropathy affecting the small sensory cutaneous nerves (nerve fibers in the skin), characterized by pain attacks starting in the feet. For example, this pain can be stabbing or burning and may be accompanied by tingly or itchy sensations. To illustrate, feelings of cold or electric shock-like pain may occur as well. In most patients, pain begins in the feet and progresses upwards, sometimes reaching the hands.

Primarly, genetic mutations or other related conditions result in small fiber neuropathy. More specifically, about 30% of small fiber neuropathy patients have the SCN9A mutation and 5% have the SCN10A mutation. With this in mind, the most common conditions that lead to small fiber neuropathy are diabetes mellitus and impaired glucose tolerance. Additionally, other conditions include Fabry disease, celiac disease, Sjogren’s syndrome, sarcoidosis, and HIV.

How is small fiber neuropathy diagnosed?

Diagnosis is primarily determined by history and a physical exam. However, functional neurophysiologic testing and skin biopsies are used as well.

How is small fiber neuropathy treated?

Treatment depends on the underlying etiology of the disease. Furthermore, exercise and weight management are necessary if the etiology is related to diabetes. Otherwise, pain can be treated with anti-seizure medications, antidepressants, topical therapies, opioids, and other forms of pain management.

What do the numbers show?

Incidentally, current available statistics on small fiber neuropathy estimate that…

  • Approximately 11 in 100,000 people suffer from small fiber neuropathy
  • Symptoms most commonly emerge in adolescence to mid-adulthood
  • Men are affected more than women
  • Diagnosis is more common in older compared to younger patients

Specifically, organizations such as The Foundation for Peripheral Neuropathy work toward reevaluating the current state of care for small fiber neuropathy and raising awareness. Meanwhile, our team at Your Autoimmunity Connection is connecting patients both with one another and with currently available resources.

Connecting you with resources

Brush up on the basics

Some of you may already have some background knowledge on small fiber neuropathy. Regardless, let’s take a moment to review the basics. Next, the following pages provide a comprehensive overview of small fiber neuropathy:

For anyone affected – Find your patient community

What’s happening in research?

  • The Foundation for Peripheral Neuropathy: Research
    • Check out this database of research articles, or participate in current research studies. 
  • PubMed: Small Fiber Neuropathy
    • Browse research articles specific to small fiber neuropathy.
  • Mayo Clinic: Clinical Trials
    • Explore Mayo Clinic’s current clinical trials.

What is one thing everyone should know about small fiber neuropathy?

Overall, when looking at the big picture, we must remember that small fiber neuropathy falls within the larger category of autoimmune and inflammatory diseases of which there are more than 100. In our research, we have found that 50 million Americans suffer from one or more autoimmune diseases. For example, a research study further estimated that approximately 25% of patients with autoimmune diseases have a tendency to develop additional autoimmune diseases.¹

All in all, we hope our spotlight on small fiber neuropathy connects you with beneficial resources and information. Most significantly, we believe it is essential to take a holistic approach to combat the autoimmune disease epidemic. By looking at all autoimmune and similar diseases together, we can move away from the fragmented view that hides the magnitude of the problem and head toward concerted action in reshaping research, diagnosis, and treatment. In particular, our model is based on the revolution in cancer research and treatment over the past 50 years. It was made possible by viewing cancer as a group of diseases with a common foundation, thus garnering far more resources than had been devoted to individual types of cancer alone. In conclusion, join us in bringing this revolution to autoimmunity!

Get acquainted with Your Autoimmunity Connection

[1] Cojocaru, M, Inimioara Mihaela Cojocaru, and Isabela Silosi. “Multiple Autoimmune Syndrome.” Mædica 5.2 (2010): 132–134. Print.


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