yes tingling and numbnees and your sensitivity to textures and clothes are common symptoms of those with small fiber neuropathy.

My skin punch biopsy was ordered by and done in a neurologists office.


I was initially diagnosed in the fall of 2003 with large fiber peripheral neuropathy via an EMG/NCS due to toxic exposures . My symptoms, which had started in late September 2001, were numbness in my feet and pain. The EMG/NCS showed that I had mild/moderate large fiber PN in my feet and mild PN in my hands. Over the years the areas of numbness moved up my legs to my knees and my lower arms. I now have severe large fiber damage in my hands, lower arms, feet and legs from knees down.

It is fairly common to have small fiber nerve damage also if you have severe large fiber nerve damage, but i did not do a skin punch biopsy when they first became avilable or for many years after because i didnt seethe point to it, since it wouldnt change treatment.

That changed for me in 2022 , when some health benefits I needed required that a diagnosis of small fiber PN be made. So I had a skin punch biopsy done in the neurologists office. I had no trouble getting approval and the procedure itself is simple, not painful and i had no side effects or complications.

Your situation is different in that your EMG/NCS showed no large nerve fiber involvement, so the next logical step, with your symptoms, is too test for small nerve fiber peripheral neuropathy. skin punch biopsy is a definitive test for small fiber pn.