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Integrated Pain Management


Small Fiber Neuropathy Explained

It is safe to say that we have all experienced some sort of random pain from doing a mundane activity. Perhaps it was experiencing a sharp pain from grabbing a glass of water late at night or a strange tingling sensation from organizing around the house, making a meal, or taking out the trash. When someone experiences pain like this, it could be for a more serious reason than we may expect. 

Small fiber neuropathy

Small fiber neuropathy (SFN) is a condition that affects small nerve fibers in the skin and possibly is the reason for all those random pains you’ve been having. It occurs when the small fibers of the peripheral nervous system, which are located outside the brain and spinal cord, are damaged. SFN can come about from many different sources such as diabetes, chemotherapy, HIV/AIDS treatment and typically begins in the feet and works its way up affecting other parts of the body such as legs, hands, arms, and torso.

This condition may sound concerning but it is not life-threatening (although it is painful) and rarely ever needs surgery. 

Symptoms vary depending on a number of factors, such as underlying conditions, but they can be debilitating. The following are just a few lifestyle changes that can help manage symptoms. 

Lifestyle Changes 

Walk the Walk

It’s no surprise that daily exercise is important to a healthy lifestyle. This is especially true for those who have small fiber neuropathy. Exercising is good for the lungs and helps build muscle. Walking helps improve blood flow in the legs and feet, strengthens and tones your muscles. Daily movement and walking is a great way to mitigate further tingling, burning, or numbness that may develop if you have neuropathy due to diabetes or other conditions. 

Super Supplements 

Life gets busy and it’s easy to forget about the little things, like taking vitamins and getting the nutrients we need every day. However, vitamin deficiency is a common contributing factor to neuropathy suffering. When we aren’t consuming enough vitamins & nutrients and aren’t absorbing them efficiently, our bodies lack the foundational nutrients that it needs to perform various tasks, such as maintaining the nervous system, healing the body, and working effectively. 

To combat the lack of vitamins and nutrients your body receives on a daily basis, the following supplements may help to support your body against neuropathic pain:

  • Vitamin B-12The body can absorb this vitamin into the bloodstream to improve reflexes, lessen pain, pricking, or tingling sensations, and provide overall nerve health. This vitamin also benefits the circulatory and immune systems. 

  • Vitamin DMany patients with neuropathy have vitamin D deficiencies if they are diabetic or suffering from peripheral neuropathy. Vitamin D supplements may help improve the symptoms of those afflicted with diabetic neuropathy and help remedy the nutritional deficit in their diet. 

  • Omega-3 Fatty AcidsFor patients with neuropathy, working this supplement into a daily regimen can help as an anti-inflammatory and decrease burning and numbness associated with pain. 

Make sure to consult with your doctor before adding any vitamins or supplements to your diet.

Happy Feet

SFN is most commonly seen in the feet, and affects the lower extremities of the body, especially tingling, loss of balance when walking, or burning sensations in the feet. Taking good care of your feet as someone who deals with neuropathy is the best way to prevent further nerve damage and muscle weakness from developing. 

  • Clean and manicure your feet every dayKeep your toenails short and manicured to avoid ingrown nails. Constantly be on the lookout for swelling, redness, or signs of tear and if you find anything unusual on your toes or feet, make sure to report back to your physician or nurse. Foot moisturizer is also recommended to care for the skin on your feet. 

  • Wear the right footwear Make sure that you are not going barefoot outside, or walking barefoot over hard surfaces. Support your heel, keep your feet inappropriate shoes. Remember to wear socks, but make sure they are on correctly. Ill-fitted socks can be bothersome to your circulation or trigger a tingling sensation in the feet. Consider foot tents to keep your feet separated from your comforter when sleeping at night, that way you trigger any sensory issues due to small fiber neuropathy. 

Serious Stuff

SFN can, unfortunately, become more complicated depending on the underlying conditions a patient may have. Due to complications, more involved treatments may be necessary to help with symptoms. There are a number of medications that can help alleviate symptoms. Over-the-counter medication such as nonsteroidal anti-inflammatory drugs (NSAIDs) can help alleviate pain and don’t need to be prescribed by a doctor. For more serious pain, a physician may prescribe more intense treatments such as: 

  • Antidepressants & Anticonvulsant Medications – These medications reduce neuropathic pain by modulating peripheral nerves, the spinal cord, or the brain. They tend to be the most effective type of medication for this condition. 

  • Narcotic Agents – Narcotic agents are another option for treatment but can lead to unhealthy dependence and addiction so they are only recommended when other treatments prove ineffective

  • Mechanical Aids –  Hand and foot braces can assist with relieving pain and physical disability caused by weakness or nerve compression

  • Surgery – Although uncommon, surgery can become an option depending on the underlying conditions and is normally only considered for pain caused by a single nerve.


SFN is a rather complicated condition with lots of varying aspects. Luckily there are a wide array of treatment options whether they be conservative or more involved. Anyone experiencing this condition should seek professional help to create a personalized treatment plan for this condition. Following doctor recommendations and changing daily habits can be crucial to pain relief and can help you get back to the quality of lifestyle you deserve.