I keep discovering how pervasive my Immune problems are.

[Carolina]

Dear Sjogren's Angels,

I have been experiencing 'flares' in various aspects of my Immune Disorders.

For example, recently my Small Fiber Neuropathy suddenly broke through the medication that kept it 'in the box'.  I take 3600 mg Gabapentin every 24 hours to keep SFN at bay.

The symptoms include burning and stinging of all the skin in my body, pins and needles in my finger tips.  Very difficult.

But this time I had terrible joint pain, a constant headache, nausea, terrible clumsiness with my hands and fingers, profound fatigue, depression.  I thought I had an infection somewhere that I couldn't identify!

I looked up Small Fiber Neuropathy and found that all of symptoms, joint pain, etc. are part of SFN.  In fact there is permanent damage to the nerves in my finger tips. No wonder I drop everything!

Now the worst of that SFN flare has passed for the time being.  And I'm exercising again and can smile at times.

from the article:

Small fiber neuropathy is the result of damage to peripheral nerves,1 including those that are small and myelinated (Aδ), as well as those that are unmyelinated (unmyelinated C fibers).2 In SFN, small somatic and autonomic fibers can be affected.1 Normally, these fibers control thermal and pain perception and control autonomic and enteric functions. For this reason, patients with SFN can present with either autonomic or somatic symptoms, or both. Symptoms are potentially numerous and can include allodynia, burning, lower thermal sensation, hyperesthesia, paresthesia, numbness in the lower extremities with potential to affect limbs and trunk, restless leg syndrome, dry eyes and mouth, abnormal sweating, bladder control issues, gastric issues, skin discoloration, and cardiac symptoms.3 Cardiac symptoms include syncope, palpitations, and orthostatic hypotension. Even without diffuse autonomic dysfunction, a percentage of patients with postural orthostatic tachycardia syndrome (POTS) can have SFN.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5912271/

Another Article

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8075405/

General symptoms are fatigue, cognitive disturbances, widespread musculoskeletal pain, headache and temporomandibular disorder [9, 10]. Somatic small nerve fibers transmit information about temperature, pain and itch [9, 11, 12]. The autonomic small nerve fibers are responsible for thermoregulatory, sudomotor, cardiovascular, gastrointestinal, urogenital and other autonomic functions.

SFN is just one of my disorders.  I keep going and hope to continue to live independently,

Elaine

[deeindiana]

Im glad it's calmed down a bit for you. A body does get so very tired. If I may ask, who treats your SFN? Rheumatologist? Neurologist? I have started getting some similar symptoms. Thanks

[meirish]

Caroline, Sorry to hear that you are having an increase in your neuropathy. I have some neuropathy but it doesn't stay the same all the time so that is a blessing. Hope that you can continue to have a reprieve from the really bothersome issues that rear their head during these flares.

You just keep on going, my friend. Wish you could have some pain free days. Always good to hear from you and it always sounds like you are able to pick yourself up and keep on keeping on. Good for you. Have a good rest of the winter. Hugs meirish

[Carolina]

Dear deindiana:

My neurologist manages my neuropathy.
A neurologist, or a physician who specializes in the treatment of disorders of the central and peripheral nervous systems, is the best physician to treat neuropathies.The definitive tests for neuropathies are done by neurologists:

Peripheral neuropathy:
 1.  a nerve conduction test (NCS), where small metal wires called electrodes are placed on your skin that release tiny electric shocks to stimulate your nerves; the speed and strength of the nerve signal is measured
2. electromyography (EMG), where a small needle is inserted through your skin into your muscle and used to measure the electrical activity of your muscles.

Small fiber neuropathy:
Skin biopsy with intraepidermal nerve fiber density evaluation is the gold standard diagnostic test.
 
A simpler way to diagnose SFN is pricking the skin with a tiny needle...loss of sensation in the affected areas indicates SFN.  Also a listing of symptoms.

And of course I already had profound PN for many years before the SFN reared its ugly head.

Elaine