If you or a loved one suffer from Small Fiber Neuropathy (SFN), or any of your patients do, you know just how painful this disorder can be. Affecting the small sensory cutaneous nerves that transmit pain and temperature information to the brain, the characteristic symptoms of SFN include unusual sensations such as tingling and prickling, pins-and-needles, sharp pricks, and even odd feelings of persistent burning and brief electric shock-like pain. Sensations of coldness and numbness are also reported, as well as allodynia (pain resulting from a stimulus that would not normally provoke pain).
Common Causes
The most common cause of SFN is diabetes mellitus, although other common causes of SFN can be HIV, celiac disease, lupus, autoimmune disorders, and even medications such as cancer drugs. Like peripheral neuropathy caused by diabetes, SFN starts in the feet and can progress upwards. In more advanced cases, SFN can affect the hands.
Pain Management through Pharmaceuticals
Conventional medical treatment for SFN today focuses on pain management involving medications to block or reduce the numerous pain-related sensations. According to the Johns Hopkins website, “Painful sensory paresthesias can be treated with anti-seizure medications, antidepressants, or analgesics including opiate drugs.”[1] Common anticonvulsant drugs include gabapentin, pregabalin, duloxetine, carbamezipine, phenytoin and others. Corticosteroids, analgesics, and topical agents such as lidocaine patches and capsaicin, may also be utilized.
Risk-Free Pain Relief with Laser Therapy
Unfortunately, pain medications provide only temporary relief, and come with a great amount of risks and harmful side effects. But Laser Therapy is non-addictive, fast-acting, and can relieve the many types of nerve pain associated with SFN without the side effects. Laser Therapy has been described as, “…an emerging treatment modality for management of neuropathic pain. It works by triggering biochemical changes within cells.”[2]
Lasers have been proven to have highly beneficial effects on nerve cells, blocking pain signals transmitted to the brain, and decreasing nerve sensitivity. Laser therapy, “is effective for disorders requiring tissue regeneration, pain relief and reduction of inflammation, treating nociceptive, neuropathic and musculoskeletal pain.”[3] Laser Therapy can successfully regenerate nerve cells, and restore nerve function. Laser Therapy “…has been used to manage nerve injuries as it holds the potential to induce a biostimulatory effect with no side effects.”[4] These benefits, especially neuropathic pain relief and nerve cell regeneration, can greatly enhance the quality of life for SFN patients.
Lasers Effectively Treat the Causes of SFN
At present, science has yet to fully study the effects of Laser Therapy on SFN. However, there have been numerous studies conducted which prove the benefits of Laser Therapy on Diabetic Peripheral Neuropathy (DPN), which is a nerve dysfunction with very similar characteristics to SFN. And since diabetes is the leading cause of SFN, these studies also give credence to Laser Therapy being an effective pain relief treatment for SFN as well as DPN. Here are just a few of these findings*:
*Please note that “LLLT” stands for “low level laser therapy.” It is a common acronym used to describe the utilization of lasers for clinical therapy. It is not unique to any specific class of laser.
- A 2019 systematic review focusing on “…finding evidence on the effectiveness of LLLT on treatment of painful diabetic neuropathy”[5] concluded that “The evidence obtained shows LLLT has a positive effect in controlling diabetic neuropathic pain.”[6]
- A 2019 pre-posttest analysis on 40 patients diagnosed with DPN concluded that, “In this study, we found that LLLT improved the QL and hence may be a useful therapeutic option in treating peripheral neuropathic pain in type 2 diabetic patients.”[7] [“QL” stands for “Quality of Life.”]
- A 2018 study evaluating “…the efficacy of low-level laser therapy (LLLT) in the management of neuropathy in diabetic rats”[8] stated, “It could be concluded that LLLT is more safe and effective than gabapentin in the management of neuropathy in diabetic rats.”[9]
In Conclusion
If you or your patients are looking for an effective, dependable, and addiction-free alternative to the negative side effects and risks of antidepressants, opioids, and other pharmaceutical drugs to manage the pain of SFN, why not try Laser Therapy? It has been proven to be even safer and more effective than gabapentin!
And in addition to pain control, studies have proven that Laser Therapy can also accelerate the healing and regeneration of nerves — so very important to those suffering from SFN. Chiropractors, physical therapists, acupuncturists, and podiatrists should seriously consider adding Laser Therapy to their treatment menus not only for SFN and DPN patients, but for all patients suffering from chronic pain and nerve injuries.
[1]www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/peripheral/never/conditions/small_fiber_sensory_neuropathy.html. Accessed 19 May 2021.
[2] M A, Ummer V S, Maiya AG, Hande M. Low level laser therapy for the patients with painful diabetic peripheral neuropathy – A systematic review. Diabetes Metab Syndr. 2019 Jul-Aug;13(4):2667-2670. doi: 10.1016/j.dsx.2019.07.035. Epub 2019 Jul 13. PMID: 31405692, p.1.
[3] Loeb LM, Amorim RP, Mazzacoratti MDGN, Scorza FA, Peres MFP. Botulinum toxin A (BT-A) versus low-level laser therapy (LLLT) in chronic migraine treatment: a comparison. Arq Neuropsiquiatr. 2018 Oct;76(10):663-667. doi: 10.1590/0004-282X20180109. PMID: 30427505, p. 664.
[4] Anju M, Chacko L, Chettupalli Y, Maiya AG, Saleena Ummer V. Effect of Low Level Laser Therapy on serum vitamin D and magnesium levels in patients with diabetic peripheral neuropathy – A pilot study. Diabetes Metab Syndr. 2019 Mar-Apr;13(2):1087-1091. doi: 10.1016/j.dsx.2019.01.022. Epub 2019 Jan 18. PMID: 31336449, p.1.
[5] M A, Ummer V S, Maiya AG, Hande M. Low level laser therapy for the patients with painful diabetic peripheral neuropathy – A systematic review. Diabetes Metab Syndr. 2019 Jul-Aug;13(4):2667-2670. doi: 10.1016/j.dsx.2019.07.035. Epub 2019 Jul 13. PMID: 31405692, p.1.
[6] Ibid.
[7] Anju M, Chacko L, Chettupalli Y, Maiya AG, Saleena Ummer V. Effect of Low Level Laser Therapy on serum vitamin D and magnesium levels in patients with diabetic peripheral neuropathy – A pilot study. Diabetes Metab Syndr. 2019 Mar-Apr;13(2):1087-1091. doi: 10.1016/j.dsx.2019.01.022. Epub 2019 Jan 18. PMID: 31336449, p.1.
[8] Abdel-Wahhab KG, Daoud EM, El Gendy A, Mourad HH, Mannaa FA, Saber MM. Efficiencies of Low-Level Laser Therapy (LLLT) and Gabapentin in the Management of Peripheral Neuropathy: Diabetic Neuropathy. Appl Biochem Biotechnol. 2018 Sep;186(1):161-173. doi: 10.1007/s12010-018-2729-z. Epub 2018 Mar 12. PMID: 29527628, p.1.
[9] Ibid.
