small fiber peripheral neuropathy involves the small nerve fibers that usually do not have a myelin sheath. Small nerve fibers in the skin subsume the sensations of touch and temperature. Damage to the small nerve fibers will not show up on an EMG/NCS Electromyography/ Nerve conduction study.


Your symptoms sound like small fiber peripheral neuropathy. A skin punch biopsy will show the amount of small fiber nerve damage you have and is used for a diagnosis. I have had it done. it was not painful and no complications afterwards at all.