Why Your EMG Can Be Normal While Your Feet Are on Fire
It’s one of the most frustrating experiences a patient can have. Your feet or hands burn, sting, or feel like they’re on fire. You’re sent for nerve tests like EMG or nerve conduction studies and the report comes back: “Normal.” You’re left wondering, “If the tests are normal, why do I feel like this?”
For many patients we see at the Neuropathy Relief Center of Miami, the answer is small fiber neuropathy a type of nerve damage that standard tests often miss. We see patients from Miami, Fort Lauderdale, Miami-Dade County, Broward County, and the Florida Keys, plus Florida, the USA, Central and South America (Colombia, Chile, Argentina, Mexico), and the Caribbean, who have been told “everything is fine” when clearly it isn’t.
What Are “Small Fibers” and Why Do They Matter?
Your peripheral nerves contain different types of fibers:
- Large fibers: Carry vibration, position sense, and some touch signals.
- Small fibers: Carry pain and temperature signals, and help regulate autonomic functions.
EMG and routine nerve conduction studies mostly evaluate large fibers. In small fiber neuropathy:
- Large fibers may still be working reasonably well.
- Small fibers, which handle pain and temperature, are damaged.
- You can have severe burning and abnormal sensations while your basic tests look “normal”.
Symptoms That Suggest Small Fiber Neuropathy
Common features include:
- Burning, stinging, or “hot” sensations in the feet or hands.
- Pain that can feel like walking on hot sand or broken glass.
- Increased sensitivity to temperature or light touch.
- Sometimes, autonomic symptoms like heart rate changes, sweating changes, or digestive issues.
- Symptoms that may start in the feet and gradually spread upward.
Some patients also notice their feet look normal, but feel anything but normal.
What Causes Small Fiber Neuropathy?
Possible contributors include:
- Diabetes and prediabetes.
- Autoimmune conditions.
- Certain infections or post-viral states.
- Toxic exposures and some medications.
- Nutritional deficiencies.
- Sometimes, no clear cause is found (idiopathic).
This is one reason we see so many small fiber neuropathy patients from across South Florida, Latin America, and the Caribbean, where metabolic, nutritional, and infectious factors can overlap.
Why “Normal” Tests Don’t Mean “Nothing’s Wrong”
A normal EMG does not rule out neuropathy especially small fiber neuropathy. That’s why some patients:
- Start doubting themselves
- Are told it’s “just anxiety” or “just aging”.
- Are offered only pain medications without an explanation.
Your pain is valid, and your nerves may be struggling in ways standard tests don’t fully capture.
How the Dr. Alfonso Neuropathy Treatment Protocol Helps Small Fiber Neuropathy
Regardless of the exact cause, small fiber neuropathy involves irritated, undernourished, and often inflamed nerve fibers. The Dr. Alfonso Neuropathy Treatment Protocol at the Neuropathy Relief Center of Miami is designed to:
- 🩸 Improve microcirculation to the small nerve fibers in the feet and hands.
- ⚡ Support nerve repair and healthier communication, helping nerves fire more normally.
- 🌿 Reduce inflammation and oxidative stress, which are key drivers of small fiber damage.
- 🧠 Support metabolic and nutritional balance, including blood sugar and key vitamins.
Many small fiber neuropathy patients report:
- Reduced burning and stinging.
- Longer periods of comfort before symptoms return.
- Improved sleep as nighttime pain calms down.
- Better ability to walk, stand, and travel.
We can’t promise to flip a switch and make everything perfect, but we can change the environment your small fibers live in so they have a better chance to function.
What You Can Do Alongside Treatment
Helpful steps include:
- 🥗 Stabilizing blood sugar (even if you’re only “borderline”).
- 💊 Checking and correcting vitamin deficiencies where appropriate.
- 🚶 Maintaining safe, low-impact movement for circulation.
- 😴 Prioritizing sleep and stress reduction, which affect nerve sensitivity.
- 🧑⚕️ Working with your doctor to rule out serious underlying autoimmune or systemic conditions.
These steps pair well with a nerve-focused protocol not instead of it.
Why Patients with Small Fiber Symptoms Travel to Our Clinic
Patients come to the Neuropathy Relief Center of Miami from:
- South Florida: Miami, Fort Lauderdale, Miami-Dade, Broward, Florida Keys.
- Across Florida and the USA.
- Central and South America: Colombia, Chile, Argentina, Mexico.
- The Caribbean.
They choose us because we:
- Take small fiber neuropathy symptoms seriously, even when basic tests are normal.
- Offer a non-surgical, drug-free protocol focused on repair, not just symptom masking.
- Understand post-infectious, autoimmune, metabolic, and idiopathic nerve problems.
- Provide bilingual care in English and Spanish.
Your Burning Pain Is Real, Even If Your EMG Is “Normal”
If your feet or hands feel like they’re on fire but your tests say “normal,” you don’t have to accept that as the end of the story.
Learn more: Neuropathy Treatment Miami
Book your consultation today: Appointments
👉 Schedule your consultation today: Call 305-274-7475 to contact the Neuropathy Relief Center of Miami.
Sincerely Yours for Health,
Dr. Rodolfo Alfonso, D.C.
8585 Sunset Drive,
STE 104
Miami, FL 33143
Ph: 305-275.7475
www.neuropathyreliefmia