My doctor and I agreed for him not to do the skin biopsy because where he was 'supposed' to do it, (top of foot, front of lower leg) I do not have pain. My pain is down the backs of my legs, bottoms of my feet, and in arms, wrists, and hands (just like carpal tunnel symptoms there). I do have occasional pain around my ankles but not frequently. He said if I had SFN, I would have pain in the fronts of my legs as well, and top of foot. I did not do the brain MRI because it was going to cost me $400. EMG's last year showed neuropathy but doc said I was probably just cold. We re-did them this year and doc found no neuropathy in my large fiber nerves. That's why we were going to do the skin biopsy. But now he has told me there is nothing else he can do for me.
This pain started in my hands five or six years ago when I was age 34 or 35. It eventually spread up my arms and began in my feet and up the backs of my legs. I had a carpal tunnel release which did not help. I am presently in physical therapy, which seems to have helped my upper arm pain, but has done nothing for my feet and calves. It does seem to have helped the pain in my butt and hamstrings.
Only prescriptions I have ever really taken is Tramadol, Hydrocodone, Darvocet (have taken a good bit of pain medicine for severe menstrual cramps). I also took Macrobid for a UTI but I already had the upper extremity pain when I did this so I don't think it's the cause. Of course I've had a few antibiotics thru the years.
I spent almost $4000 this year on chelation treatments. None the better.
I've had 2 orthopedic doctors dismiss me and now this neurologist. Just wondering if this could still be SFN. The pain is burning, pinching, sometimes electric shocks. Doesn't usually keep me up at night unless I have been on my feet 'too much' which means not much. The pain is worse when I am on my feet, or when I use my hands too much, especially for small motor movements like typing or cutting up something. I am a new member and any insight is appreciated!

It can appear in any part/s of the body or all of your body.
I can't believe that doctor told you it could not be SFN because you didn't have pain in any one specific place.
Mine was in my upper body before it spread like wildfire to my whole body. You need a new doc. Do you have episodes of numbness, tingling, wet drops, shooting/ throbbing pain?
Some of the doctors aren't schooled on non length dependent SFN. They look for the typical stocking and glove pattern which is more common.

The only problem is, you already have the meds so there isn't much they can do about it except give you name for it.
Have you had a spinal tap, autoimmune blood work up, full body/ brain MRI? Have you been heavy metal tested? Have you had a work up of vitamin/ minerals?

I do have all of those symptoms except for the wet drops. I don't know why he couldn't do the biopsy where I DO have pain. What is non length dependent SFN? I actually don't take anything but natural stuff so far. Sometimes I use the Tramadol but it really just makes me 'care less' about the pain-doesn't actually take it away. I have considered lyrica/neurotin, but trying to hold off. I was heavy metal tested and showed a little high for lead and antimony. Did chelation for 3 months which didn't help me at all. I haven't had a spinal tap. Is that real painful? I'm going to get a new neurologist! I'm also seeing an allergy doc this month-my physical therapist suggested this. Do you know what caused your neuropathy?

You have classic presentation for SFN and you should find another doctor/neuro!! The skin biopsy is not necessarily done only on places where pain is at. The most common place for pain is the bottom of the feet yet NO skin biopsy is ever done on the bottom of the feet!!

You really need to so another neuro with more experience...and the skin biopsy would be an appropriate test for you (with site being done at ankle, just below knee and thigh (to determine length dependent or not).

There is literally 100+ causes of neuropathy and you just have to work through various testing (most obvoius causes first) to see if you can determine which is causing yours.