Small fiber neuropathy is really an interesting condition 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 nerve conduction study. So what I tell patients and actually residents or students who train under us is that a normal nerve conduction study does not exclude a neuropathy. And we will confirm this by doing additional testing, specifically the nervous the the examination at the bedside asking patients about their.
Symptoms, for example, loss of sensation to cool or or hot temperatures, loss of pain sensation and also doing skin biopsies where we look at nerve densities in the skin both from the calf and the thigh as well as doing a special test that looks at sweat function both in your foot in in the legs as well as the feet to gauge the level of small fiber nerve damage. Small fiber neuropathy typically will progress unless the underlying cause is identified and reversed. Diabetes of course being the most common cause is always screened.
For. but once the more common causes are excluded and the focus becomes on excluding any underlying secondary disease process but also controlling pain because if patients’ symptoms of pain are generally controlled they tend to do pretty well and really have no other major functional deficits. I’ve really become interested over the years is how interconnected neurology and rheumatology are and one thing I often do on patients who have unexplained small fiber even autonomic neuropathy is have them see rheumatology or get evaluated for connective.
Treating Neuropathy and Nerve Pain in the Feet
Let me start with im a diabetic. i developed neuropathy, which basically you lose all sensation in the feet, but its over a period of time. It was very painful. I would have sensations in my feet like I was standing on fire, walking on glass. Last October it got so bad that I couldnt sleep at night. Then I met Bullard, because hes just a great physician. I wouldnt think twice, Id recommend him to anybody. Very compassionate, very thorough, I cant say enough about Bullard. Hes just a great physician and I dont know.
If theres anything he couldnt do he could probably move mountains if he wanted to! Glen, probably one of the biggest questions people are asking you is whatd we do, whats happened. Of course, you had a tremendous improvement in your pain and the tingling and the numbness. Easiest explanation is, to tell everybody, that this big nerve here, which is on the inside part of your left foot, was getting strangled. There was a noose around it. What we did is we went in and loosened.
The noose, and that allows that nerve to begin to function and work like its supposed to. Now, the sensation is coming back, its something thats going to take time but I can feel more. My quality of life has greatly improved since I had the procedure done by Bullard. Theres no other physician that I would recommend. Glen, in the next couple weeks, what were going to do is make sure that the swelling is improving, hopefully begin to transition.