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Hi Nodsirrah, welcome to this forum. SFN is hard to diagnose as well as find out why. The skin biopsy gave you a SFN diagnosis. I had a sural nerve biopsy that revealed my diagnosis of SFN & NSVN. Why I have this is unknown. You may be right with the why, that is for someone else on this forum to comment on(not my expertice).
Best pain medication for this is Lyrica 300 mg twice a day, cymbalta 60mg once a day with a narcotic for breakthrough pain. A Pain Clinic Dr. can help you manage your pain. Best of luck to you. June

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