06/12/2026
Small fiber neuropathy (SFN) is a condition that affects the small sensory nerve fibers responsible for transmitting pain, temperature, and autonomic signals. When it involves the ankle or feet, it can cause symptoms such as:
- Burning pain around the ankle or foot
- Tingling or "pins and needles" sensations
- Numbness or reduced sensitivity
- Sharp, stabbing, or electric shock-like pain
- Increased sensitivity to touch or temperature
- Symptoms that are often worse at night
Small fiber neuropathy typically starts in the feet and ankles and may gradually spread upward in a "stocking" pattern. Common causes include Type 2 Diabetes, prediabetes, autoimmune disorders, vitamin deficiencies, certain medications, infections, and sometimes no identifiable cause is found.
Diagnosis often involves a clinical examination, nerve testing, and sometimes a skin biopsy to measure nerve fiber density. Treatment focuses on addressing the underlying cause when possible and managing symptoms.