Small Fiber Neuropathy Symptoms Diagnosis and Treatment
Small fiber neuropathy is really an interestingcondition because it consists typically of just burning, numbness, pain of the feet,sometimes the hands later on without necessarily having any abnormalities on your EMG or nerveconduction study. So what I tell patients and actually residents or students who trainunder us is that a normal nerve conduction study does not exclude a neuropathy. And wewill confirm this by doing additional testing, specifically the nervous the the examinationat the bedside asking patients about their symptoms, for example, loss of sensation tocool or or hot temperatures, loss of pain sensation and also doing skin biopsies wherewe look at nerve densities in the skin both
from the calf and the thigh as well as doinga special test that looks at sweat function both in your foot in in the legs as well asthe feet to gauge the level of small fiber nerve damage. Small fiber neuropathy typicallywill progress unless the underlying cause is identified and reversed. Diabetes of coursebeing the most common cause is always screened for. But once the more common causes are excludedand the focus becomes on excluding any underlying secondary disease process but also controllingpain because if patients' symptoms of pain are generally controlled they tend to do prettywell and really have no other major functional deficits. I've really become interested overthe years is how interconnected neurology
and rheumatology are and one thing I oftendo on patients who have unexplained small fiber even autonomic neuropathy is have themsee rheumatology or get evaluated for connective tissue disorders like lupus or Sjogren's orsarcoid and sometimes even if we are not directly involved in treating the patients, this canbe the first sign of an underlying connective tissue disorder that can then be brought tothe attention of rheumatology and addressed from their standpoint.
Periripheral neuropathy burning and cramping pain no more
Alright well we're here with one of our greatpatients Verne. How are you doing today Verne? I'm doing fine. Verne has been with us forabout six weeks now. He initially contacted us about our neuropathy treatment protocolthat Busch developed. Verne had quite a bit of different symptoms going on withyour neuropathy. Can you tell us a little bit about what you were feeling from a symptomstandpoint before you called in? I was getting pains down the back of my legs and down intomy feet. I had numbness under my feet and pains in my toes. And these pains were realsharp and shooting? Yes. Now you also had some burning pain, is that right, when yougo to sleep at night? Can you describe that
a little bit for me? It was mostly in my feetand it was kind of a burning sensation in my feet. Now how did that affect your sleep?I know we've talked a lot about how you were sleeping before you came in here, can youtell me what it was like for you to try to sleep at night? Well I really couldn't getmuch sleep, I had to get up and walk around and then I'd go back and get an hour or soof sleep and finally I would sleep in my chair, recliner. I was gonna say, do you have a reclinerthere? Yes. That's where you did most of your sleeping is that right? Yes. I know this weekwe've gotten to a big milestone here where you're getting to sleep in your bed now, whichis fantastic. Your daughter got you a nice
mattress topper for your mattress, the painis no longer keeping you awake at night, is that right? That's right, yes. The burningpain is 100% gone at this point so that's fantastic, and those sharp shooting painswere going all the way down your leg from the thigh all the way to the foot, those aregone all the way now for the last week or so and the only place you're having anythingnow is a little bit in the toe on your foot is that right? So overall, how much betterare you feeling now do you think compared to when you first came in? Oh I feel 100%better. Changes your whole life doesn't it? Yes. You're able to sleep through the nightnow and makes your whole day better when you
wake up refreshed and sleeping allows yourbody to heal itself naturally which is part of the whole process. So overall how muchbetter is your quality of life at this point compared to what it was? Oh it's a lot better,100% better. Don't feel that hopeless feeling about the neuropathy and that sort of thing.I know you and I have talked a little, but Verne did you ever feel you would get to thislevel of improvement, and what do you say to me? You didn't feel like you could didyou, you thought it was something you'd have to live with for the rest of your life. Yea.Partly because that's what you'd been told by some other s. Well hopefully soonwe'll have you off the gabapentin that they
have you taking which is a common thing forit. Living life every day and doing the things you want to do. Well thank you for your time,we love having you here as a patient, and we look forward to seeing you in the future.Well thank you. You're welcome.
Treating Numbness Tingling and Burning Caused by Neuropathy
My name is David Northcutt. I'm oneof the podiatrists here at Dallas Podiatry Works. Today I want to discuss diabetic peripheralneuropathy. There are several reasons for the development of peripheral neuropathy,but diabetic peripheral neuropathy is one of the most common. Diabetic peripheral neuropathy simply meansnerve damage that is caused from having diabetes. This is not something that develops rapidly,but is a slowly worsening and progressive condition which happens over the period ofseveral years. The loss of sensation that occurs with nerve damage from diabetes makesthe patient more prone to developing open
sores or ulcers. Patients often do not know that they havea sore or wound, due to this lack of sensation. This can lead to significant complicationsincluding amputations. Diabetic peripheral neuropathy usually occurs in patients whodo not maintain their blood sugar well, however it can occur in anyone with diabetes. The symptoms of neuropathy include numbness,tingling, pain, burning in the feet which can progress up to the legs, there's oftenloss of muscle tone, loss of balance, and changes to foot structure. To determine whetheryou have diabetic peripheral neuropathy, a
history and physical will be performed. Simple,in office, noninvasive testing helps to diagnose the problem. Neurologic tests sometimes areordered. Sometimes a biopsy of the peripheral nerves in the skin may also be performed.Treatment of diabetic peripheral neuropathy begins with good control of your blood sugar.There are oral medications as well as topical medications that may reduce your symptoms.Prevention of diabetic peripheral neuropathy includes maintaining good blood sugar levels. If you have any symptoms of numbness, burning,tingling in your feet or legs, please give us a call at Dallas Podiatry Works. We willwork to get the correct diagnosis to help
relieve your symptoms.