Small Fiber Neuropathy

What is small fibre neuropathy?

Small fibre neuropathy is a neurological disorder (neuropathy) of all the nerves in the body (polyneuropathy). It can be accompanied by pain when these nerves do not work properly.


The cause of the pain in small fibre neuropathy is unknown. There is however a link to other diseases such as diabetes, sarcoidosis, thyroid disease and infections, for example.

Signs and symptoms

Patients complain of constant pain in the hands and feet. The pain can be either burning or acute in nature and it can come in waves. But itching, deep stabbing pain and pain elicited by contact with heat are also reported. There may also be other impairments such as a reduction or absence of sweating, excessive blushing, low blood pressure when standing up and bladder and bowel problems. The feet are sometimes painful to the touch.

How is small fibre neuropathy diagnosed?

A general physical examination and an extensive neurological examination are highly important. The following tests should be included in the neurological examination: (1) sensory tests of the arms and legs, (2) reflexes and (3) strength tests.

Do I need additional examinations?

What are my treatment options?

Multidisciplinary Treatment

Depending on the cause of your pain, your pain specialist will decide whether or not to embark on physical treatment. Based on the results of the completed pain questionnaire, additional examinations can be carried out and, apart from physical treatment, other methods of treatment will be suggested.

Non-physical Treatments

If the results of your pain questionnaire are abnormal, your pain specialist will offer you one of the non-physical treatments listed below:

Physical Treatments



Other Treatments

Interventional Pain Treatments

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