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I have Type II and assume I have diabetic neuropathy as I do have some areas that feel partially numb. But I also have degenerative disk disease & have various bulging/herniated disks.

My problem is [U]constant[/U], individual pin ***** sensations that occur anywhere on my skin, but mostly in the lower half of my body. Some are not too painful, like being stuck lightly with the head of a pin. But some are much stronger & painful, similar to getting stung by a bee, or being stuck with a much larger needle. I'm not talking about "pins & needles" or a tingling sensation. These are always single jabs that can occur anywhere, many times per hour. Light scratching or rubbing them stops the sensation immediately. When they first started I was freaking out wondering if I had bugs in the house! These jabs are especially infuriating when I'm trying to sleep - if I try to ignore them, they don't go away. They're quite insistent. It's terrible when I'm in public and they're in a place where I can't rub!

I'm not sure if this is considered neuropathy or not, as I never see other people talk about it online. If this sounds familiar, I'd sure like to hear from you. Especially if you've found something that helps to stop it!

Donna M.
Hello Donna. I had to create an account just to respond and let you know that you are not alone in your symptoms. I have had a form of neuropathy called Non-Length Dependent Small-Fiber Neuropathy (NLD-SFN) for several years now and one of the symptoms I have are the random individual pin-***** sensations you mention. They can range from a mild annoyance to a very intense deep, almost a hot/searing-type of needle-like focused sensation.

From what my neurologist at Washington Univeristy here in St. Louis has told me, these are random firings of dead/damaged small-fiber nerves (c and a-delta types of fibers) similar to "phantom nerve pain" that amputees have. The damaged nerve is firing a signals saying "I'm damaged, there must be an injury," and normally those signals are blocked over time, but sometimes a signal can "break through" and cause the symptoms I (or we) feel.

If possible, I would recommend seeing a neurologist or simply someone who can test you for small-fiber neuropathy. The gold-standard test for this form of neuropathy is a skin-punch biopsy because damage to these fine nerve fibers cannot be detected with EMGs or nerve conduction tests. The biopsy is relatively painless procedure where they remove a patch of skin about the diameter of a pencil eraser from a few places on your body and then count the number of nerve fibers present. If the density is too low or they see strange nerve growth, they will diagnose you with neuropathy of the small nerve fibers. Depending on where the damage is worst, they can normally determine the pattern of progression as well.

I hope this info will help and that you don't feel alone in your symptoms. Best of luck to you and I hope you find relief from your suffering.

SFN Warrior
Thanks for your reply, Warrior. I'm sorry to hear of your NLD-SFN diagnosis. Are there other common symptoms associated with NLD- SFN? I'll have to think about going the biopsy route. If a neurologist took, say, 3 patches of skin, what are the odds that those particular skin samples would show low nerve density or unusual nerve growth?

You didn't say if there is treatment available for SFN. Have you found any relief?

Thanks again!
Sorry for the delayed response, Donna. Holidays and travel for work have kept me from personal endeavors for a while. I tend to get a little downtime while I am on the road and I wanted to write a reply.

I don't think I can post links in this forum, but if you seach "small fiber neuropathy" in Google you will find a ton of info regarding symptoms, causes, and treatments. The symptoms of small fiber neuropathy are the same regardless of whether the presentation is length-dependent or not: burning, stabbing, aching, tingling, and numbness. If your autonomic nerves are affected you could also have trouble with blood pressure, sweating, digestion, sexual dysfunction and more. The websites you can find online provide more extensive lists of symptoms.

Regarding the skin biopsy, there are specific locations where the doctor will take them from due to the fact that only certain locations have had enough research done to provide norm values that can be measured against. Odds are that one of the locations would show something if the small fiber nerves are affected. Based on which of the locations shows the most damage, they will be able to tell you the pattern of involvement (length vs. non-length dependent).

Treatment depends on the underlying cause of the neuropathy. There a lot of different causes (#1 cause being diabetes), but almost half of all cases are "idiopathic" meaning that no cause for the damage can be found. My case is currently labeled idiopathic as there is a unspecified autoimmune disease going on with me that they cannot nail down as of yet.

I hope those answers help a bit and that you are able to get your tests run soon for some peace of mind. Hang in there and let me know if you have any other questions.

All the best,
SFN Warrior
Thanks for your reply, Warrior. I have researched online about SFN and the symptoms sound all too familiar. Very interesting about the autonomic nerves, because I DO have problems with HBP, digestion and excessive sweating!

You've been so helpful. You hang in there, too!
Best of everything to you in this new year,
Donna M.

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