Small Fiber vs. Large Fiber Neuropathy: How to Tell the Difference (and What Miami Patients Can Do)

“Neuropathy” isn’t one-size-fits-all. Understanding the type of nerve fibers affected can explain why your symptoms feel the way they do and how to treat them more effectively.

Here’s a clear, Miami-focused guide to small fiber vs. large fiber neuropathy, and what you can do about each.

Small fiber neuropathy (SFN): The “burning & sensitivity” type

What it affects: Thin sensory fibers that carry pain and temperature information.
 Common symptoms:

• Burning, stinging, or “sunburned” feeling
• Pain from light touch or sheets
• Temperature sensitivity (hot/cold misreads)
• Often normal strength but sleep and mood suffer from persistent pain
  

Common triggers: Diabetes/prediabetes, autoimmune issues, celiac, B-vitamin problems, chemo, toxins, thyroid dysfunction.

Large fiber neuropathy (LFN): The “numb & unsteady” type

What it affects: Thick sensory fibers (vibration, position) and sometimes motor fibers (strength).
 Common symptoms:

• Numbness; “walking on padding”
• Poor balance (especially in the dark)
• Weakness, cramping, reduced reflexes
• Trouble feeling the gas pedal or judging steps
  

Common triggers: Diabetes, spinal stenosis/disc problems, B12 deficiency, long-standing alcohol use, chronic compression injuries.

Can you have both? Yes.

Many Miami patients present with mixed patterns burning pain (small fiber) and balance changes (large fiber). That’s why a targeted evaluation is essential.

What we do differently in Miami

At Neuropathy Relief Center of Miami, we match care to the fiber type(s) involved:

• For small fiber symptoms:
  
  
  • Red/infrared light to support cellular energy and calm hypersensitive fibersGentle desensitization routines, temperature management, and sleep strategies
  • Metabolic guidance for glucose and inflammation
    
• For large fiber symptoms:
  
  
  • Vibration and balance retraining to restore proprioceptionStrength and gait drills tailored to your abilities
  • Pulsed electromagnetic field (PEMF) to support circulation
    

Most plans blend both tracks because your neuropathy is unique.

Bilingual, local, accessible

Hablamos español. We serve Miami-Dade from Kendall to Coral Gables, Brickell to Westchester, and welcome patients from out of state and Latin America.

Get clarity. Get a plan. Get moving again.

Understanding your neuropathy type is the first step toward results that matter less pain, more stability, and safer steps.

📞 305-274-7475
 📍 8585 Sunset Drive, Suite 104, Miami, FL 33143
 Book online: https://www.neuropathyreliefmiami.com/contact/