Small Fiber Peripheral Nerve Biopsies for Neuropathy

The peripheral nerves come from the peripheral nervous system. These nerves read signals from the brain and spinal cord so we can move and feel sensations throughout the rest of the body. Small fiber neuropathy is a condition that results from nerve damage. A tingling or shooting pain often originates in a hand or foot and spreads to the rest of the body.  Since these nerves control what we feel, how we breathe, and our perspiration, patients suffering from small fiber neuropathy may have a hard time breathing, sensitivity when touching objects, and experience an impaired sweat response.

What to Expect
In order to treat the condition, physicians must first test to see if the pain is due to small fiber neuropathy. TriState Pain Institute physicians can do this by performing a skin biopsy. Patients will lie on their side as physicians draw five circles about one inch in diameter. They will go on the upper arm, wrist area, upper thigh, lower leg, and the foot. Then, the physician will use a disinfecting agent to clean the area and inject each site with anesthetic. Once they feel numb, the physician will cut a small circle into the skin and remove it from each area. Even though it is small, there are actually nerves living just under the skin that the physician will collect. Overall, patients should not expect the procedure to take more than 30 minutes.

After the Procedure
After the skin samples are collected, the area will be cleaned and dressed with a bandage. We advise patients against driving home after the procedure, but they are able to return home shortly after the procedure. Patients might experience localized pain once the anesthesia wears off. However, since the area of skin removed is small, it should heal quickly.

The sample will be sent to a lab for testing to evaluate whether the nerves have sustained any damage or disease. The lab will send TriState Pain Institute physicians the results in about one to two weeks. If the lab says the diagnosis is confirmed, we can move forward and start to talk about treatment options.

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