I have Small Fiber Neuropathy, which causes my legs, feet, arms and hands to feel either numb completely, pins/needles, achy, sharp pains, and sensitive to the touch. At night, these symptoms seem to get worse and my legs are the worst of all. They keep me up. Is there anything I can do or take to lessen the pain?

Raganp:

It is very common, and almost a defining characteristic of SFN that the pain is worse at night. Unfortunately, how to treat the pain is a difficult thing to figure out.

The only real way to treat SFN is to find and treat the underlying cause. I believe your other post indicated that you are considered ideopathic at this point, but that's often the diagnosis when the doctors don't want to "waste" any more time or money figuring it out. Sometimes you have to keep pushing to get the doctors to keep testing and looking for causes.

When you don't know the cause, I always suggest that the best thing you can do is to examine your overall lifestyle. Improve your diet, exercise to the extent that your condition allows, and reduce stress. Some neuropathies are related to vitamin deficiencies, etc., - and even when they aren't, many people find some relief by taking supplements. (There's a ton of info in this forum regarding supplements that may help.)

Beyond that, it comes down to medications to achieve pain relief. You can try over the counter pain relievers, but they generally don't work well for SFN (unless it is caused by some kind of inflammation). If you have limited areas that bother you, using Epsom lotion or a topical cream like biofreeze might help - but it's impractical if your symptoms are body-wide.

Then you're down to prescription meds. The front line meds for most doctors include anti-convulsants like gabapentin or lyrica - or anti-depressants. Sometimes short term use of sleeping pills helps if you are becoming sleep deprived. There are lots more things beyond that - but hopefully the less drastic options will work for you.

Mortons Epsom Salt Lotion helped me when my feet were too tender to touch on the top of them. I was able to start using bedsheets again. Ragtop pretty well laid down the protocol, I just jumped in to say that the symptoms you are having now might not stay this bad or will change over time. So you hang in there and find relief. I have been free of Ambien now for two weeks after using it for two years. But I do not regret using it as you need at least 5 hrs sleep at night for healing. I am having trouble getting the old 5 hrs now but I am over the hump on my pain symptoms and I will take the time to work on my sleep pattern reset. Good Luck, Ken in Texas.

Just to reiterate what Ragtop said...improve your diet. More specifically, cut back on sugar and carbs in general, as well as processed food. Higher blood sugar levels are an insult to nerves, and you can have issues in that area that are undetected by the normal diabetes screening tests.

I'm not nearly as miserable as I was last year with my SFN, and I can only cite my improved diet and maybe two supplements as being the cause of improvement. The supplements are high quality fish oil and R-Lipoic Acid.

I suppose I should also add that I have less anxiety about the condition which is also helpful. Anxiety will make it 100 times worse for me.

If you are not on regular daily meds, you can ask your neurologist to prescribe something for occasional very bad nights.
And get Netflix so you can watch back to back episodes of shows.

I have posted here about my right foot nasty pain some nights, last night it came on again. Thinking all along with arthritis pain now thinking it neuropathy in this right foot, right side of body is hip replacement side and all the mess I deal with from it.

Last night I rubbed my foot with topricin and satured it with tea tree oil and pain went away and I got back to sleep. This only happens at night like 3AM. I sleep in socks.

Do lower blood sugar levels help even if you are not diabetic?

You can have blood sugar issues without being a diagnosed diabetic or even pre-diabetic. I'm not even diagnosed as pre-diabetic, yet if I eat a really high carb meal, my blood sugar can spike to 200 and stay elevated for hours. From what I've read, a normal person can eat anything they want and never go above 140, and probably not coincidentally, that's the level at which point many seem to believe cellular damage can start occurring.

This is just my opinion, but if you haven't done home monitoring or haven't taken the Oral Glucose Tolerance Test, then you don't know for a fact you don't have glucose issues and you don't know whether your blood sugar is spiking to high levels or not.

Since cutting back on refined carbs, processed food and sugar is generally considered to be a healthier way to eat anyway, I can't see not doing it.

I have this too. Someone here on this forum explained that the reason it's worse at night usually is because our tendons are still when we rest. This allows the nerves in our peripheries to transmit signals to the brain faster via our tendons. The reason the pain in feet and hands is so much worse is because we need these to respond the fastest to emergencies such as a fire or whatever. Not sure if I've got this quite right or not but I found it somehow very consoling as an explanation.

I'm lying in my bed right now in severe pain in both hands and feet. In my case I think it's part of the rheumatic disease process but this hasn't been properly acknowledged by my doctors yet and I'm not on any medications for the underlying disease now either. I think the reason it's worse tonight than it has been for a few weeks is because I am tapering off steroids slowly - down to 1mg yesterday. Personally I haven't found any natural cure that works. I'm gluten free and only eat healthy, wholesome foods, mostly avoid sugars and my blood glucose levels are entirely normal, as are most of my bloods apart from inflammation levels which fluctuate. I exercise, keep busy and still this thing plagues me day in day out - for over two years now. Sorry you have it too. 😟

Everything is worse at night.

Hugs, ElaineD