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Common symptoms of SFN include: Burning pain, typically beginning in the feet and sometimes spreading to the hands Sharp, shooting, or electric-like pain Numbness and tingling Allodynia (pain from normally non-painful stimuli, like light touch) Hyperalgesia (increased sensitivity to pain) Autonomic symptoms such as abnormal sweating, blood pressure fluctuations, digestive issues, and bladder dysfunction Skin changes in affected areas SFN can be particularly challenging to diagnose because standard nerve conduction studies, which are commonly used to evaluate peripheral neuropathies, primarily assess large fiber function and often miss small fiber damage