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.
Peripehral Neuropathy Painful Legs and Feet Pain Reduced DavisSpineInstitute
When you originally presented to the officeyou presented very very intense peripheral neuropathy pain over your knee, lower legs,and feet. We've been managing you here for a good six weeks on the peripheral neuropathybased program. How have you been responding to the program, and what's been your experiencestoday? When I first started it took a while before I was able to say that and feel animprovement in my problem. Particularly on the bottom of my feet, the sensory part. Icould feel the difference between tile and wood floor, the coldness of each and the carpet.Before I started the program I hardly could feel the difference between those items. Thediscoloration of the neuropathy on my legs
is a great improvement and I'm very pleasedwith that. It does not, particularly on my right leg, it does not weep water anymore,the skin does not break, and that is a great improvement as far as I'm concerned. On myknees there is some swelling going on on my right knee, there is improvement on the insideof my knee. The outside is still a little bit numb, the inside is better and the scartissue that I had on my legs is feeling great now. No discomfort when I touch it and thatis a great improvement. Well congratulations on your results, we're very very proud tohave you here as a patient. Thank you. I'm happy to be here it's been quite and experience.Thank you.
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.