Small-fiber neuropathy may initially just cause numbness and tingling, and even itchiness. Symptoms often progresses to an intense burning or stabbing pain. It typically begins in the feet, hands, or both, but it can involve any part of the body.

Small fiber neuropathy can cause pain, as well as loss of sensation. Small fiber neuropathy may also cause autonomic dysfunction because small nerve fibers help mediate digestion, blood pressure, and bladder control.

A small fiber neuropathy occurs when damage to the peripheral nerves predominantly or entirely affects the small myelinated (Aδ) fibers or unmyelinated C fibers. The specific fiber types involved in this process include both small somatic and autonomic fibers.

Small fiber neuropathy has a benign course but can affect quality of life; individualize treatment to control underlying causes and alleviate pain. Small fiber neuropathy (SFN) is common and can be associated with many medical conditions, including reports of an association with COVID-19.

Small fiber neuropathy presents with burning pain, often beginning in the extremities, most notably in the feet. It is due to the involvement of A-delta and C nerve fibers. It may occur idiopathically or due to metabolic, hereditary, infectious, immune-mediated, or toxic etiologies.