What You Need to Know About Peripheral Neuropathy and Fibromyalgia

The Link Between Fibromyalgia and Small Nerve Fiber Neuropathy

The concept of pain without any obvious cause is what fibro sufferers are familiar with. Recent studies suggest that nerve damage may play a bigger role in fibromyalgia.

Two separate studies conducted in 2013 and 2015 found evidence of a condition known as small nerve fiber neuropathy (SFN) in fibromyalgia participants. SFN is also a pain disorder and shows similar symptoms to fibromyalgia such as pain, burning sensations and tenderness in the hands and feet. In SFN, patients exhibit impaired small nerve fiber function resulting in increased pain. These studies suggest that the root of fibromyalgia pain may actually be neuropathic for some.

A simple test, known as punch biopsy, can be done to determine if you have small nerve fiber neuropathy. Consider taking this test if you are suffering from fibromyalgia. It can mean discovering treatment options for your condition. If you want to do a punch biopsy, speak to your doctor to get referred to a dermatologist for the biopsy.

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  1. says: Sharon Swoboda

    My fibromyalgia pain is throughout my body, head to toe 24/7/365. I have spinal stenosis, bulging disks and degenerative disk disease which certainly adds to the pain. I’ve developed Interstitial cystitis which is not uncommon for fibro sufferers. Those are just the tip of the iceberg, as they say. Everything else I have is chronic, too. It is only by the Grace of God that I can endure at all. May God continue to bless and keep each of you who have fibromyalgia and other health issues as well.

    1. says: Brigette Fraser

      I have all 3 of those you mentioned, with the fibro…is there a reason why all 3 would be there? I also wonder if RH O Negative blood would have anything to do with it?

    2. says: Deb Roberts

      Hi. I am new to this group. Your post just opened up so much for me in the terms of my chronic illnesses! I wonder if you might have it in you to have a chat session sometime and see if you might help my knowldege further.
      If so that would have terrific!
      I will leave you with my info and I will hold my breath that you may find some time to talk. Haha
      I have severe COPD, and a laundry list (truly not holding breath).
      Actually, I see now see that I am responding through/from an email I received. In this case, anyone out there that can chat on this subject. Please feel free.
      ☮️ Peace–Deb

    3. says: Winifred Mckeever

      Hi I have spondalous and have have 7 ops on my back, everything I get the doctors blame it on my back. But after reading your email I’m wondering if I have fibromyalgia, as I have pain 24/7 , can you tell me who diagnosed you , thank you. Winifred x

    4. says: Susan

      It would be so nice if we had a national voice to have more questions answered. I am one of the unlucky ones and have had so many bad reactions to so many meds. I was symotaniously diagnosed with Fibro and PSA in the same month Oct 2016. I also have hystoplasmosis scars in my eyes that make literally one med on the market to keep my joints from further damage. Otezla. I’ve been off and on it for just a year and I’m now having 24/7 nausea. I just want something to keep me upright and able. My family Dr treats me with Hydrocone and muscle relaxers , day time and night time nausea meds, but I’m just about at the end of my rope with meds. I just want a few good days. 55 is too young to fall in a hole.

      1. says: Audrey van den Hoven

        I’m now trying marijuana oils. CBD for daytime pain, THC Indica to sleep at night. Neither oil has any intoxicating effects. I’m getting fair pain control during the day with some T3 supplementing, but the THC at night is amazing. I go to sleep so much easier without the side effects of sleeping pills.

  2. says: Rose

    I have pain from fibro 24/7 also, with the neuropathy too, also IBS and Interstitial Cystitis. I’ve been getting sort of burning pains sporadically on the sides of my feet & hands, which I’m assuming is part of the neuropathy.

    Brigette – no clue, but I am AB negative.

  3. says: Bea

    I would like to know what people are taking for their pain. I have fibro, IC and IBS and cancer. My doctor wants me to go off tramadol. It’s the only medicine that helps my pain. Any advice?

    1. says: Carol

      So sorry to hear of all your health challenges. May I ask why your Dr recommends going off the tramadol? It has been the only pain meds that has worked for me. I have degenerative disk, herniated disks at L4/L5, sciatic, fibro diagnosed 12 years ago, 3 open heart surgeries in the past 4 years to correct aorta dissection, thoracic & abdominal aneurysms.

      I hope your cancer, IC & IBS are in remission. Peace

    2. says: Julie. Sherry

      Hi Bea my name is Julie, and l have had Fibromyalgia plus Lupus for 15 years
      and l have tried a lot of different pain killers, the best one l find that works
      is Kapanol 20mgs SR taken twice daily and useing Endone 5mgs for break through pain. I hope it helps it works well for our Fibro group of ladies 36 now
      but make sure your on a good antinflammation pill it helps.
      Send me a message if you have a question only to happy to help. Regards
      Julie Sherry

    3. says: Mrs Sharon brotherton

      Hi bea… i asked to be put on gabapentin because it helps to calm the nerves down… you start on a small dose which rises weekly or monthly. I have meralgia parathetica and allodynia in my left thigh. Staryed with a slipped disc. Hope this helps xx

    4. says: Colleen Ektefaie

      Tramadol did nothing for me. I am on major meds over past 4 years mostly due to having major neck surgery for cancer that caused nerve and muscle damage along with having my Fibro pain increase in intensity and never letting up. extended release morphine along with oxycodone instant release for break through pain. I have tried all Fibro meds none worked and all had symptoms. Have tried all natural (acupuncture, massage therapy etc) supplements and minerals.

      Please try either LDN-Low Dose Naltrexone ( if you do not take opioids -they will knock them off your recptiors) If on opioids like myself there are 2 alternatives-
      ULDN – ultra low dose Naltrexone or
      Micro dose Naltrexone can work for some
      I do the ULDN and had to educate my pain management dr about it and printed off info I collected online when that did not work I contacted a compounding pharmacy and they came out to see my dr to explain the scientific process. I started to fill my ULDN With them but it was expensive $95 a month so more research online and Facebook has a group for Low dose Naltrexone and I learned that you can dilute it yourself (reg. Pharmacies only have Naltrexone 50mg and my insurance covers it I’m sure most do) I cut it in half and again in half so that gives me 12.5mg I crush pill and dissolve in 12.5 ml then I use a pippette (amazon) Ted extract the dose I need. It was having great impact on pain levels like nothing I’ve ever tried before. Unfortunately I got Valley Fever (fungal infection from soil that goes airborne in California and Arizona) since then it’s not doing anything. But still using in hopes it will again. Also heard this along with Ketamine (need prescription and dr. Needs to dose correctly) works majic.

      Also I had the Fm/a blood test to confirm my diagnosis

    5. says: Cheryl Toole

      The problem with Tramadol is that you develop a tolerance for it and so you need to frequently up the dosage and in many cases it will eventually stop working. Although it gets a bad rap for drug addicts, I have been using oxytocet for 10 years now. I have stayed on the same daily dose (4) and do have some extra for breakthrough pain on very bad days. I have never been tempted to misuse it and I never have felt high while taking it. I know a lot of people are scared of it but it has saved my life and made me more functional. I must add though that I have more than fibro wrong with me; I have degenerative disc disease, a non surgical injury at L4-5/LA -S1 in my spine, osteoarthritis everywhere especially at sites of 19 fractures, have bad migraines and have had a total knee replacement in my mid 50’s. I am a bit of a mess and pain has become a daily fact of life. My meds do keep me going though, as without them, I probably would have killed myself by now. Luckily I have a very caring Doctor, but he does monitor me with random drug tests to make sure I am sticking with the plan. I attend a pain clinic every month for a spinal epidural every other month and an IV infusion of lidocaine and torodol also every other month. I also suffer from a serious mental illness where various addictions are common, so I would think if anyone were to misuse it, clinically it would be me. I know how much I need it however so I would never jeopardize abuse that would result in my bring taken off it. Not for everyone obviously, but worth a try for some.

  4. says: Rose

    I’m so sorry Bea, that you’re having to fight that beast, cancer, as well as chronic pain. I’m sorry I have no answers though, as I haven’t taken anything for all my pain except for headaches, I take Excedrin and migraines, I have a prescription.

  5. says: Cheryl Cartino

    I also have pain from head to toe 24/7 with flares of severe pain. Some days it’s even painful to wear clothes! Nothing has worked for my pain but neurontin has helped with the burning pain in feet and ankles. I also work a full time job and a part time job… both desk jobs and both are from home thank goodness! I have back issues. I wish everyone experiencing chronic pain the best! May God bless us all

  6. says: Jackie Boyd

    I have A Pos blood. My latest shooting nerve type pains are in my forearms, top of wrists into top of my hands, I was just told by my Orthopedic Dr= Tendonitis. Rest them as much as I can and wear braces. I do have Carpal Tunnel symptoms in both but this is now in addition to that.

  7. says: Lucy

    I’m Rh a neg and suffer both with migraines and have had both carpal tunnel ops on both hands tramadol and neurontin and oxyContin are the only pain relief that seems to work. Being a chef it’s hard to keep going but We do don’t we.
    Busy having a major flare up at the moment,, but hubby doesn’t understand,, I like you all wish this condition was curable, and hope you are all keeping well xx

  8. says: Funky

    I understand what u r talking about…I use. “Turmeric Curcumin with black pepper” I take 4-6000 mg per day…if I hurting I try this first… If it works for u it’s suppose dose wonders for all kinds of things… google it.
    Feel better

  9. says: Sioned Williams

    I feel like someone has a voodoo doll on me. Sticking pins in me. Then pain in hands if they get cold till i could cry. Or chop them off. When i walk the dogs my shoilder start hurting and my foot will twinge. My neck tendons (i call them my deadrie rasheeeds ) they twang like someone flicking a lastic band. Im scared to move. There was one time i litreraĺly moved my eyes down to the right and something clicked in my neck, i couldnt move for days. I hate it. Ive now ordered cbd capsuals and iodene as i have underactive thyroid. And i use cannabis. I will never take meds off dr again. I was on pregablin and cytralopam i had to come off them as i found out i was pregnant. It was horrific. Cold tukey is not the word my whole body would shake like a chicken walking is the only way i can describe it. And the pain was all over. The cannabis got me through. Cant wait to try the capsuals. Anyone else experience these symptoms.

    1. says: Ladybug

      I just went to a seminar on CBD oil, it was very informative.. sounds like it might be a life saver! Make sure you get the right kind though because there is a lot out there that your body doesn’t obsorb enough of it to do much good .. the kind she recommended was a spray that you spray in your mouth and wait 60 second or so then swallow.. CBd oil is not only good for fibromyalgia it is good for cancer, crohns, anxiety, asthma, glaucoma and much more .. everyone should google it .. I am going to try it as soon as it arrives here in my province. I can get some at shops here but it isn’t the quality I am looking for .. I also have a lot of pain and have tried meds but I can’t function on them. I work so I need my brain to work as much as possible.. It’s hard when your in constant pain but I do my best to get through the day ! We all do what we have to ! Hope this helps !

  10. says: Carol Doughty

    I am in pain all day long with my hands feet and my back i have Buprenorphine patch but i still feel pain .

  11. says: Kim

    I have been diagnosed with Fibro for 13 yrs now, have RA, spinal stenosis and Chronic Fatigue. Recently I am experiencing a new pain. It is low in my pelvic area. I had a hysterectomy 3yrs ago. CT scan showed nothing. Feels like it is in my pelvic bone, but radiates from one side to another. Has anyone else had anything like this before?

    1. says: Becca

      I have pain mostly in the left side of pelvis, I think its my ovary. I too had a hysterectomy but they left my ovaries. I was diagnosed almost 3 yrs ago with fibro. I also have DDD, severe facet degeneration on right side. I recently had a new type on injection on my L4,L5 and S4 . So far it seems to be helping. This was after numerous other injections, PT, accupuncture, massage therapy and laser spine surgery. Ive been on medical leave since July 2017 with no sign of my Dr releasing me back to work. Good luck everyone with continued support

    2. says: Molly

      In reference to low back pain in left or right pelvic area. I have been treated for many years for not only fibro but degenerative disc, stenosis, spondolythesis,, etc. Apparently, Dr.’s have not really been paying attention to pelvis. Recent studies showed I have a separated pelvic joint. Two bones in pelvis: Ilias and sacrum. There is normallly a small separation during pregnancy. My pain Dr. is one of few doing new surgery to screw it back together. My insurance does not cover this.. Am having a series ablation injections – that burn (or kill?) the irritated nerves. They recover after time though – thus the series of treatments.

      1. says: Tanya


        I have fibro, small fiber neuropathy. I have burning sensations in my feet. I also have bulging disks in lower back. I just had the ablations on L3, L4, and L5 you mention. They are called Radio Frequency Ablations. Pain doctor is hoping they will last for a year before the nerves regenetate.
        But as of now, it is working. I even moved and back pain stayed away. Normally, if I moved after injections I had it would reaggravate the pain. But then I just had epidurals. I. wish all the best for you and hope your ablations help you a lot.

  12. says: Shari

    No clue on the importance of blood type but I am A POS so I kinda doubt that’s significant. It seems like all blood types can be affected.

    As far as treatments go, I had tried Prednisone, Gabapentin, Amitriptyline (among other meds – all unsuccessful) before my insurance would allow me to try Lyrica. Within 2 weeks of starting Lyrica, I felt noticeably better. I was just a shell of a person but now I live with less pain … It’s still there and I still struggle but my pain level can be managed now. And I am still on disability because I can’t even work part-time. The effects are short-lived so I have to take 3 doses per day just to maintain a tolerable pain level but it does work. Good luck and God bless all of you.

  13. says: Glenna

    Hi lady’s I read a study done on fibromyalgia not to long ago and it said that it found 9 out of 10 people (women) with this had been sexually abused at one time or another in there lives!! Of the people I know well with this we all have been and it seams really odd to me , but maybe that’s why it’s a problem with the nervous system!! IDK!!

  14. says: Nancy

    I am in major pain daily. Have problems sleeping. And a whole list of the side effects that go with fibromyalgia. I have been on an antidepressant and 2 pain meds which has been working great not taking all the pain away or the flare ups but it has helped me to be able to do things. The government is trying to crackdown on the street drugs so they are now giving the doctors a hard time about prescribing the pain meds. They don’t. Are about people like us that is in constant pAin. So guess what my pain meds are getting cut down to lower dosages. Come night time around 5 pm my legs hurt so bad I can hardly walk. The doctors reply to all this is I have to live with it. Great life to look forward to.

  15. says: Anne Pilon

    I had a stroke in 1998 so I haven’t worked since it was caused by a clotting disorder a blood clot in my brain stem since then I have been diagnosed with fibromyalgia I also have stenosis and aggravated sciatica I cannot stand stress it causes me to have severe headaches I also have vertigo on there wild scale of 1 to 10 it depends on what days and what stress level I have in my life I also have acid reflux so I have to be very careful with medications Gabapentin gave me severe constipation I also have read that irritable bowel syndrome is associated with fibromyalgia I am O positive so I don’t believe that blood type is totally the cause I also have found that cannabis is very helpful with all of my symptoms

  16. says: Donna

    Cheryl Cartino. You say you work at home which is a blessing. I have health.issues like yours and wondering if you can give me any info on what kind of job you have to be able to work from home. I have been looking for work that can be done at home.

  17. says: June

    I take Gabapentin, recently it hasn’t worked as well but it did for several years. I took Lyrica for 10 months prior and gained over 50lbs it didn’t like me..lol, I’ve taken every drug recommended..they don’t work. I’ve tried veganism for 18 months, twice. Next up is cbd cannabis. I’ve heard good things.
    I have overall body pain 24/7. Recently it has moved into my feet. I have everything described in the article as well as chemical sensitivity. Actually I have most of what all of you describe. I am certainly awaiting the day when this is figured out. The fatigue and the constant pain keep me from living the life I want but I remain hopeful. Meditation has been keeping me in the game. Best wishes to you all. I know your struggle.

  18. says: Dee

    Hi i got diganoised i have Fabromyalgia few month nack due to going to Doctors constincley feeling had flu .thats what Doctors where saying.
    I had to go back as felt been hit all over with a hammer. Im 55 a very acctive person so finding it very hard. Having bad time at minute but not to a lot of people bless yas all .i went out to beqch with partner on way back felt ill had to go to bed woke up 5 hrs later in tears felt like been hit all over with hammer
    Vommited a lot bwfore going back to sleep felt ill thought was dying . I manag3d to get Doctors appointment hear i had a very high temprature in which also caused my Fm off and other symtumes off .felt so poorly .got Antibiotics now been taken for 3days .i feel ive got somebidy elses head as it feels not right excuse mt spelli g as that and maths have seem to gonw hay wire cant seen to smell or even notive the differnce any more .
    I feel for all of you’s .its such a Horrible Disease .some Dotors look at you as if yoir making symtumes up .

  19. says: Shelley

    I am reading a lot of us also have problems with our spines which makes me wonder if this has a big effect for fibro, I have tried everything that has been suggested to try and help and there is nothing I am about to give up and admit to myself that nothing can be done, I can’t stand this pain, I am trying one last thing that my chiro suggested to help with the inflammation and hopefully take away some of the pain and that is to go gluten free, has anyone else tried this

    1. says: Jackie Skidmore

      I tried gluten free. I honestly can say my inflammation was a little better, but if you eat anything with gluten, the pain comes back. I also agree I think this is tied to back pain.

  20. says: Corinne Giles

    How or where do you do “punch biopsy.” This is good information, but we need a source, please. Thank you for your help with this debilitating disease.

  21. says: Ruby

    I am wondering if any of you with fibro have a sensitivity to fabrics. I can only wear soft cotton. I do wear jeans but they must be light weight.
    And if not I will start to itch and hurt all over.

  22. says: Jaime Jeffer

    I feel like this article ended abruptly and without explaining exactly what a punch biopsy is, how it’s done and why and how it would relate to fibromyalgia. I went to the next page assuming the article went on, but it didn’t. Maybe a more thorough writing of articles on here would be better.

    1. says: Emily Brown

      Punch biopsy is a test to check if you have small nerve fiber neuropathy. Small nerve fiber neuropathy is another type of pain disorder which exhibit similar symptoms to fibromyalgia such as burning sensations and tenderness in the hands and feet. Hope this helps.

      Thank you for your feedback. We would definitely work on having more detailed content.

      Best, Emily

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