--for full body small-fiber neuropathy possibilities?

I was given a referral to a rheumatologist in the capital of our state since it's only 45 min away from where I live. And the rheumatologist examined me for fibromyalgia or any other rheumatology reason and determined that I didn't have it. And I was also sent to the neurologist and gave me a nerve conduction test which came out normal and showed no findings of peripheral neuropathy or any other emg findings on the test and suggested I begin taking a multivtamin, which I haven't done. But I was sent to a dermatologist about 8 months ago and 6 months ago determined that I had extremely dry skin as well dermatitis. And the next appointment the dryness was getting a little better but I was still having horrible pain. So, the pain she believed was coming from the allodynia and gave me a prescription of gabapentin for 300 mg tablets to take 1 to 3 times a day. as well as giving me lidocaine patches and I've consistently done the gabapentin but not consistently the lidocaine patches as well as keeping up with moisturizing my skin.

What is small fibers neuropathy?

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.

You really think my symptoms sound like this condition I totally thought it was allodynia because of my clothing issue with the fabrics. Who could I ask to do a small skin biopsy? Could I ask my dermatologist to do it?

So, my skin sensitvity to the textures of clothes as well as the fittedness of clothes and my legs going numb and having a tingling feeling after sitting for a while. All of this could be small fiber neuropathy? Can I ask what you're symptoms were and did you end up getting diagnosed with it? Also, who did your skin biopsy, was it a dermatologist?

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.

Thank you so much for your advice. Maybe in July when I see my dermatologist I'll tell her about even with the medication, the pain doesn't stop unless I use the lidocaine on my body. Because she said last time if the medication didn't work I might have to go see a neurologist.