What is Small Fiber Neuropathy?

Small fiber neuropathy is a painful type of neuropathy that can be difficult to detect or diagnose with routine testing. People with small fiber neuropathy usually experience severe sharp or burning pain, with some sensory symptoms and no significant weakness in their body.

Routine tests, like nerve conduction studies, do not help detect small fiber neuropathy. Additional testing, such as quantitative sudomotor axon reflex testing (sweat testing) or a skin biopsy is needed to make a definitive diagnosis.

Small fiber neuropathy can be caused by diabetes and various other types of inflammatory or noninflammatory diseases. Sometimes small fiber neuropathy may be associated with either partial or global autonomic failure and this can be detected through autonomic testing.

Early diagnosis of small fiber neuropathy and identifying the underlying cause helps with managing symptoms. Most individuals will need medication for nerve pain along with treatment for the underlying cause of neuropathy.