Idiopathic SFN based on symptoms and ruling out major causes of SFN with four MRIs, several rounds of bloodwork, and a spinal tap. My neuro didn't think the punch biopsy was necessary.

I'm better than I was last year when diagnosed. Possible reasons are less anxiety about it, better diet (low sugar/processed food), supplement regimen, shift in hormones. I don't take anything for pain now.