Small fiber neuropathy is a type of peripheral neuropathy that typically causes pain, tingling, or numbness in the hands or feet, and sometimes in other body parts as well. Because many different conditions can cause this type of neuropathy, treatment for it often depends on a diagnosis. At Chetco Medical and Aesthetics in Gold Beach, OR, we offer services to help diagnose the cause of this condition, which can help at pinpointing which of the following treatments may be most appropriate.
What Is the Treatment for Small Fiber Neuropathy?
Lifestyle and Dietary Modifications
When there’s an identifiable cause of small fiber neuropathy, simple lifestyle changes, diet modifications, or vitamin supplements can often lead to major improvements and sometimes even complete reversal of the condition. For this reason, any of the following recommendations may be made:
Among identifiable causes of small fiber neuropathy, diabetes is the most common cause. When diabetes or a prediabetes state is implicated, making changes in your diet to balance glucose levels can often lead to major improvements or even reversal of this nerve condition. Another causal condition is celiac disease, and when this is the case, switching to a gluten-free diet is normally recommended.
Sticking to a regular exercise regimen can not only boost the body’s natural healing process by reducing stress, but it can be especially useful in reducing neuropathic symptoms. When these symptoms are a secondary cause of diabetes, exercising can help control blood glucose levels by increasing the body’s sensitivity to insulin. It can also help to directly stimulate neuron regeneration, which means that small nerve fibers can benefit greatly from certain types of exercise.
Sometimes the culprit can simply be a vitamin or mineral deficiency, which is potentially reversible in many scenarios. Vitamin B12 deficiency is a particularly common cause of various nerve disorders, which is why it’s important to undergo blood testing for any deficiencies.
If it’s discovered that you are low in specific vitamins or minerals, supplements may be recommended to correct the deficiency. This can sometimes lead to either quick or gradual improvements and even the disappearance of neuropathic symptoms altogether.
In some cases, medications can be a causal factor in nerve fiber changes because many are neurotoxic. For this reason, changes in the medications you’re taking may be recommended by your doctor if it’s determined that they are a possible cause of your symptoms, and if it’s deemed likely to result in an overall improvement of your health condition. Some medications can also affect the absorption of certain vitamins, which is another reason why medication may need to be reduced or switched to an alternative.
Pharmacotherapy for Pain Management
The pain that often occurs with small fiber neuropathy can be debilitating, especially when it occurs in multiple areas of the body. For this reason, many pharmacological medications have been studied in the treatment of this type of pain and are sometimes prescribed. Medications that you may be prescribed can include:
When the cause of any neuropathic condition is idiopathic, meaning that it hasn’t yet been identified, antidepressants are a commonly prescribed treatment for treating the associated pain. Two classes of antidepressants, TCAs and SNRIs, have shown considerable promise in helping many pain sufferers regain their functionality and lives back. Because certain neurotransmitters in the body, such as serotonin, play a role in how the brain perceives pain, these medications can help to decrease that perception.
Some antiepileptic medications, such as gabapentin and pregabalin, are considered to be first-line treatments for neuropathic pain. Similar to some antidepressants, they can affect how pain messages are transmitted to the brain. Excitatory neurotransmitters, such as glutamate, are believed to play a role in this process, and some antiepileptics can reduce the amount of glutamate and other excitatory neurotransmitters released in the body.
Some topical treatments, including lidocaine, can reduce pain when applied directly to the skin. When lidocaine is prescribed, it can come in cream, gel, or patch form. This treatment can be particularly useful in cases of focal pain, which is when the pain is emanating from a small, specific area.
When the symptoms of neuropathy occur suddenly, rather than gradually over time, there may be an inflammatory factor that’s causing it. Corticosteroids are sometimes given for this reason and have shown to be effective in some cases where the condition was idiopathic and had an acute or sudden onset.
Less commonly, analgesics are sometimes prescribed for neuropathic pain, with opioids being the most prominent type prescribed. Considered to be a second-line form of treatment for severe cases, these medications work by blocking the body’s pain signals from reaching the brain by attaching to receptors within the brain, spinal cord, and other parts of the body.
When pain or other symptoms of small fiber neuropathy are present, the following alternative nonpharmacologic options can sometimes be very efficient at improving quality of life, depending on the cause of your symptoms.
Transcutaneous electrical nerve stimulation is a process where a device, known as a TENS unit, sends electrical impulses to sticky pads attached to the skin. This can lead to both the reduction of pain signals sent to the brain, as well as stimulation of endorphins, which are the pain-relieving hormones that the body produces.
As an adjuvant therapy, Low-level laser treatment has shown beneficial effects when it comes to reducing neuropathic pain, particularly in some cases of diabetic neuropathy. It works by producing increased blood flow to the areas where it’s applied, which can encourage both nerve healing and the reformation of thicker nerve fibers.
Some forms of massage can reduce neuropathic symptoms such as pain, tingling, and numbness when done correctly and appropriately. Massages can boost circulation to the areas where nerve damage has occurred, which is necessary for the process of nerve fiber regeneration to take place. For maximum effectiveness, massage therapy normally has to be performed regularly on an ongoing basis and can be self-administered once a qualified practitioner has taught you the appropriate techniques.
Practicing relaxation techniques can often lead to pain reduction for some sufferers, as well as improvements in quality of life. When in a tense state, the body is using fewer resources to repair itself while also producing stress hormones, such as epinephrine and cortisol. These hormones can not only affect the nerve regeneration process but can also lead to increased blood sugar levels in the body, which can greatly affect those with diabetic neuropathy or prediabetes. Meditation, breathing exercises, and self-focused mindfulness are all techniques one can use that may help.
Targeted acupuncture, which involves having needles inserted into the skin in specific areas, can help to re-stimulate nerve fibers. It does this by boosting blood flow to the damaged fibers within the skin. This type of alternative therapy can also lead to decreases in pain perception as the body releases more pain-reducing endorphins in response to it.
Many autoimmune disorders can cause neuropathic issues, including Lupus, HIV/AIDS, and Sjogren’s syndrome. When an autoimmune disease has been identified as the likely cause, immunotherapy in the form of intravenous immune globulin may sometimes be beneficial. This treatment involves receiving an infusion of antibodies that your body would normally produce to boost immunity and fight off infections.
Detecting Early Stage Small Fiber Neuropathy
Small fiber neuropathy caused by some disorders can be detected early with our SudoScan device or prevented before it starts with an accurate diabetes screening.
SudoScan for a Timely Diagnosis
How Does SudoScan Detect This Condition?
One of the earliest manifestations of neuropathic degeneration is a dysfunction in the sweat glands, which you may or may not notice. This occurs because some of the nerve fibers that play a role in this condition, C-fibers, have a major impact on the autonomic nervous system. Once C-fibers begin to degenerate, this can then affect sweat gland activity. SudoScan can detect these activity changes, which can help indicate which treatment plan may be suitable.
How Long Does the SudoScan Process Take?
The SudoScan process typically takes less than five minutes in our clinic. It requires no preparation on your part, no fasting, and is non-invasive. Using light electrical impulses, we can determine if the sweat glands in your hands or feet are releasing adequate amounts of chloride ion, an electrolyte found in sweat. In a single visit, we’re often able to diagnose both autonomic nerve dysfunction and small fiber neuropathy, depending on the cause.
Diabetic Screening for Early Prevention
We also offer a comprehensive diabetic screening service, which can help with preventing long-term nerve damage. If you suspect you may be at risk for diabetes or suffering from prediabetes already, it’s crucial that this is diagnosed and treated before serious complications occur.
Find the Best Course of Treatment
When it comes to treating or preventing small nerve fiber neuropathy, a timely and accurate diagnosis is extremely important so that the best treatment plan can be pursued. Contact us today at Chetco Medical and Aesthetics in Gold Beach, OR to discuss your options and schedule an appointment.