Written by: Bonnie Feldman, DDS, MBA, Anna Simon
Autoimmune disease is an “invisible epidemic.” Despite affecting roughly 16% of the US population, autoimmunity remains under-recognized, under-researched, and under-served. To combat this lack of awareness and to connect patients, families, and caregivers with useful resources, we at Your Autoimmunity Connection are publishing a series of “spotlights” on autoimmune diseases or other diseases that are closely linked to immune dysfunction.
Our new spotlight shines on small fiber neuropathy. Continue reading to become connected with available statistics, research initiatives, supportive patient communities, and more! Be sure 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. This pain can be stabbing or burning and may be accompanied by tingly or itchy sensations. 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.
Causes of small fiber neuropathy primarily stem from genetic mutations or other related conditions. About 30% of small fiber neuropathy patients have the SCN9A mutation and 5% have the SCN10A mutation. The most common conditions that lead to small fiber neuropathy are diabetes mellitus and impaired glucose tolerance. 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. If the etiology is related to diabetes, exercise and weight management are necessary. Otherwise, pain can be treated with anti-seizure medications, antidepressants, topical therapies, opioids, and other forms of pain management.
What do the numbers show?
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
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
While some of you may already have some background knowledge on small fiber neuropathy, let’s take a moment to review the basics. The following pages provide a comprehensive overview of small fiber neuropathy:
- Johns Hopkins: Small Fiber Sensory Neuropathy
- Read about symptoms, diagnosis, and treatment options.
- US National Library of Medicine: Small Fiber Neuropathy
- Read a more in-depth description of symptoms and causes.
- Mayo Clinic: Peripheral Neuropathy
- Learn more about small fiber neuropathy’s overarching condition, peripheral neuropathy.
For anyone affected – Find your patient community
- The Foundation for Peripheral Neuropathy: Peripheral Neuropathy Support Groups
- Find a support group near your location.
- Drugs.com: Small Fiber Neuropathy Support Group
- Ask questions (or answer them) about medications related to small fiber neuropathy.
- Mayo Clinic: Living with Neuropathy
- Join this safe place where you can meet other people who are dealing with neuropathy.
- Facebook groups & forums:
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?
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. A research study further estimated that approximately 25% of patients with autoimmune diseases have a tendency to develop additional autoimmune diseases.¹
We hope our spotlight on small fiber neuropathy connects you with beneficial resources and information. 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. Our model is based on the revolution in cancer research and treatment over the past 50 years, 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. Help us bring this revolution to autoimmunity!
Get acquainted with Your Autoimmunity Connection
- Check out our blog at www.drbonnie360.com for all things autoimmune – updates in research to possible lifestyle modifications, patient stories, and more.
- Find us on Facebook here, or join our Facebook Forum to connect with patients across all autoimmune diseases.
- Read our patient guide on How to Achieve Your Optimal Wellbeing
- Read our Guide to Movement Therapy
- Read our Guide to Food Therapy
- Read our guide on How to Thrive with a Chronic Disease
 Cojocaru, M, Inimioara Mihaela Cojocaru, and Isabela Silosi. “Multiple Autoimmune Syndrome.” Mædica 5.2 (2010): 132–134. Print.