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.
New Effective Treatment for Tarsal Tunnel Syndrome
Are you suffering from burning tingling andnumbing in the bottom of your foot? For years the practice of performing the oldprocedure for tarsal tunnel produced a 40 to 60% failure rate because only this tunnelat the laciniate ligament in the ankle was released. Our new approach is designed to relieve pressureson the nerves in not only the tarsal tunnel which is similar to releasing the carpal tunnelin the hand, but now we know at least three more tunnels in the foot that must be addressed.This allows for normal function to return to the nerves. This is done for relievingburning, tingling and numbness and this is
critical. This has increased our success rate to 85to 90% success rate from the old failure rate of 40 to 60%. Now we know to release the superior calcanealchamber containing the medial plantar nerve supplying the bottom inside of your foot andtoes. The inferior calcaneal chamber containingthe lateral plantar nerve supplying the bottom outside of your foot and toes. And the smaller medial calcaneal nerve tunnelswhich may be 1 or more branches supplying
the inside and bottom of the your heel. These ligaments or fibrousÂ tunnels are carefullyreleased to create more space which relieves the pressures at each of these nerve tunnelsorÂ quot;chokepointsquot; allowing for the return of normal nerve function. Post operatively we incorporate Physical rehabilitationsuch as neural gliding, and aqua therapy, to encourage restoration of motor and sensorynerve function. Therapeutic lasers to enhance your healing process through photobiomodulationand Nutraceuticals to provide quot;fuelquot; for your nerves to heal.
Remember the longer yours nerves are compressed,the more damage occurs to the axon or quot;corequot; of the nerve and this makes it more difficultto resolve the burning, tingling and numbing in your foot and restore normal sensationso early intervention is recommended.