Neuropathy Condition
Small Fiber Neuropathy
The neuropathy a standard EMG can miss.
Small fiber neuropathy is damage to the smallest nerve fibers — the ones that carry pain and temperature signals and help run automatic functions. It causes burning, stabbing, and hypersensitivity, often with completely normal EMG results. Your symptoms are real, and they have an explanation.
By Dr. Logan Swaim · Last updated July 8, 2026
- 4.9 from 625+ Google reviews
- Caring for the Suncoast since 2016
- Led by the author of a book on reversing neuropathy
- Drug-free & surgery-free program
Understanding Small Fiber Neuropathy
What It Is & Why It Happens
Your peripheral nerves come in sizes. Large fibers carry strength, vibration, and position sense; small fibers carry pain and temperature and help regulate automatic functions like sweating. Small fiber neuropathy means the small fibers are damaged while the large ones may still be working — which is why you can have burning feet at night and still pass a strength test with flying colors.
This is also why so many small fiber patients feel dismissed. Standard EMG and nerve-conduction studies primarily measure the large, fast fibers — they can come back completely normal while the small fibers are genuinely struggling. If you've been told 'your tests are fine' while your feet burn, itch, or stab, small fiber involvement is one of the most common explanations. The symptoms were never in your head; they were in fibers the test wasn't designed to see.
There is genuinely hopeful news here: small fibers have meaningful regenerative capacity when the environment around them improves. Because small fibers depend heavily on healthy microcirculation, our program focuses on measuring and supporting exactly that — circulation, inflammatory load, and sensory function — with objective testing at the start and progress re-exams along the way. An honest assessment of how much fiber function remains always comes first.
Common Symptoms
Signs You May Be Dealing With Small Fiber Neuropathy
- Burning pain, usually starting in the feet — often worst at night
- Sharp, stabbing, or electric-shock sensations
- Pins and needles or prickling that comes in waves
- Hypersensitivity — bedsheets or light touch feel painful
- Trouble telling hot from cold accurately
- Itching, crawling, or 'bugs on the skin' sensations with nothing visible
- Changes in sweating, or feet that look red or feel hot
How We Help
Our Treatment Approach
Dr. Logan Swaim, MS, DC has spent years specializing in peripheral neuropathy. Every program begins with a comprehensive nerve function assessment before any treatment is recommended.
- Comprehensive baseline testing: 16-point sensory exam, circulation assessment, and balance testing — the functional measures small fiber problems actually show up on
- Careful history to identify likely drivers (blood-sugar trends, autoimmune factors, nutritional gaps) and coordinate any needed medical workup
- Red light therapy (photobiomodulation) to support the microcirculation small fibers depend on
- Chiropractic neurological care to support the structural environment of the nervous system
- Nutritional guidance where deficiencies commonly accelerate small fiber damage (B vitamins, alpha-lipoic acid, magnesium)
- Objective progress re-exams so improvement in sensation and circulation is measured, not guessed
Treatments That Help
Therapies Used for Small Fiber Neuropathy
Neuropathy Treatment
Reversing nerve damage without surgery or medication. Dr. Logan Swaim wrote the book on it — literally.
Learn MoreRed Light Therapy
Medical-grade red light therapy in a private, full-body room. Our DAHLIA Pinnacle Bed supports chronic pain, recovery, skin health, gut and neurometabolic health, and weight management — as part of a personalized care plan. Photobiomodulation that goes beyond a consumer sauna.
Learn MoreRelated Conditions
Other Forms of Neuropathy We Treat
Read More
Articles About Small Fiber Neuropathy
Small Fiber Neuropathy: What It Is, Why It Burns, and Why There's Still Hope
If you've been told nothing more can be done about your burning, tingling nerve pain, here's what small fiber neuropathy really is — and why you deserve another conversation about what's possible.
Read ArticleHow Is Neuropathy Diagnosed? The Tests, Explained
From sensory exams to nerve-conduction studies: the tests behind a neuropathy diagnosis, what each measures, and why 'normal' results don't always end the story.
Read ArticleWhat Causes Neuropathy? The Main Culprits Explained
You've been told you have neuropathy. Now the real question: why? Understanding what caused your nerve symptoms is the first step toward figuring out what can actually help.
Read ArticleCommon Questions
Frequently Asked Questions
Drug-Free Care Options
How our program supports small fiber neuropathy
Neuropathy Evaluation & Testing
Objective testing that shows what's actually happening in your nerves — circulation, sensation, and balance.
Balance Testing & Training
In-clinic balance measurement and retraining — because falls, not foot pain, are neuropathy's biggest everyday risk.
The Roots Neuropathy Program
Our structured, drug-free program built around the four things struggling nerves need most.
Red Light Therapy for Neuropathy
Painless 15-minute light sessions that support circulation — a core piece of our nerve-care plans.
Chiropractic Care for Neuropathy
Gentle, instrument-assisted care that supports the nervous system behind your symptoms.
Shockwave Therapy
Focused acoustic-wave treatment used where indicated to support circulation and tissue healing — 8–15 minutes per session.
Nutritional Support
Practical guidance on the nutrients nerves depend on — and the deficiencies that quietly work against them.
Next Step
Hear Dr. Logan explain your condition — before you commit to anything.
Our free neuropathy seminars cover the science behind nerve damage, what a comprehensive assessment looks like, and which patients are candidates for our program. No sales pitch. No obligation.
Visit The Roots Neuropathy
One clinic. One focused neuropathy program.
Dr. Logan Swaim, Dr. Laura Swaim & Dr. Grayson Fox
Meet the full teamThe Roots Neuropathy
a program of The Roots Health Centers
8209 Natures Way, Unit 115
Lakewood Ranch, FL 34202
(941) 877-1507- Mon
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Ready to understand
what's driving your neuropathy?
Schedule a comprehensive evaluation with Dr. Logan Swaim, MS, DC and get a clear picture of what's actually happening — and what can be done about it.
*Includes consultation, 16-point sensory exam, circulation assessment & balance testing