Nikhil Prasad Fact checked by:Thailand Medical News Team Jun 14, 2025 3 weeks, 3 days, 9 hours, 32 minutes ago
Thailand Medical News: Millions of people suffering from long COVID are now facing a painful and debilitating new complication—small fiber neuropathy (SFN). This nerve condition, characterized by chronic pain and strange sensations, is increasingly being linked to both COVID-19 infection and vaccination. Now, researchers from the Renaissance School of Medicine and the Department of Anesthesiology and Pain Medicine at Stony Brook Medical Center in New York have published a comprehensive review exploring this troubling phenomenon.
Shocking Rise in Long COVID Nerve Damage Explained in New Medical Review
Small fiber neuropathy is a nerve disorder that damages the tiny sensory and autonomic nerves responsible for pain, temperature, and involuntary bodily functions. In many people recovering from COVID-19, these symptoms can emerge weeks or even months after the initial infection has cleared. According to the study review covered in this
Thailand Medical News report, up to one in three people with long COVID may experience symptoms suggestive of small fiber neuropathy (SFN), including burning sensations, tingling, and even pain from light touch such as bedsheets brushing against the skin.
What Is Small Fiber Neuropathy and How Does It Present?
Small fiber neuropathy (SFN) can manifest in two forms. The more common “length-dependent” form causes pain in the hands and feet in a glove-and-stocking pattern. The less common “non-length-dependent” form causes pain in the face, trunk, or upper legs. These patients often experience excruciating sensations like electric shocks, itching, or coldness. Allodynia—pain from harmless touch—is a red flag symptom of SFN.
But small fiber neuropathy (SFN) isn’t just about pain. It can also affect involuntary bodily functions. Patients have reported trouble with urination, digestion, and even blood pressure regulation, pointing to damage in the autonomic nerves as well.
The Mysterious Link Between COVID-19 and Nerve Damage
Although small fiber neuropathy (SFN) has long been associated with diseases like diabetes, HIV, and hepatitis C, researchers believe COVID-19 may trigger similar nerve damage. The exact reason remains uncertain, but several theories are gaining traction. Some scientists believe that COVID-19 triggers an autoimmune reaction, where the body’s immune system starts mistakenly attacking its own nerves. Antibodies—usually meant to fight viruses—have been found in COVID-19 patients with nerve pain, suggesting an immune connection.
Another theory suggests direct viral damage. COVID-19 is known to bind to ACE2 receptors found in nerve cells. This could explain why some patients experience long-lasting nerve issues, even if their infection was mild. There’s also evidence that a severe immune response known as a “cytokine storm” may inflame and damage small nerves throughout the body.
Some experts believe COVID-19 may not cause small f
iber neuropathy (SFN) outright but may unmask an underlying nerve issue in vulnerable people. Regardless of the root cause, the resulting symptoms are often life-altering.
Current Treatments and Hope on the Horizon
There is no one-size-fits-all cure for small fiber neuropathy (SFN), but several treatments are showing promise. Doctors typically start by trying to reduce symptoms. Gabapentin and pregabalin—drugs that reduce nerve signals—are often used to manage pain. Antidepressants like duloxetine and nortriptyline can also help by modifying pain pathways in the brain.
Topical treatments such as lidocaine patches can numb painful areas, while opioids like tramadol may be considered in severe cases, despite the risk of addiction. Corticosteroids have shown some success in reducing inflammation, especially in younger patients with fast-onset symptoms.
One of the most intriguing approaches involves intravenous immunoglobulin (IVIG), a treatment that helps calm the immune system. Some patients with post-COVID-19 SFN have experienced major relief after receiving this therapy, though more research is needed to confirm its benefits.
Non-drug options like acupuncture, essential oil massage, and electrical nerve stimulation are also being explored. These approaches may provide temporary relief and are especially appealing for patients who cannot tolerate pharmaceuticals.
Final Thoughts and Future Directions
This newly published review provides critical insight into how SARS-CoV-2 can lead to painful long-term nerve damage in the form of small fiber neuropathy. The researchers emphasize that while treatments are available, a deeper understanding of the underlying causes is urgently needed. Small fiber neuropathy (SFN) can dramatically affect a person’s quality of life—impacting sleep, digestion, bladder control, and causing relentless, life-limiting pain.
A multidisciplinary approach is required for diagnosis and treatment. As the virus continues to evolve, healthcare providers must remain alert to emerging complications like SFN. There is a growing need for precision medicine—treatments tailored to a patient’s immune profile and history—to help those suffering from post-COVID neurological symptoms.
In conclusion, the study highlights that small fiber neuropathy is not a fringe condition but a central and serious consequence for many recovering from COVID-19. While not every long COVID patient will develop small fiber neuropathy (SFN), those who do deserve early recognition, compassionate care, and access to effective treatments. As the world moves forward, acknowledging and addressing these neurological aftershocks of the pandemic will be essential for public health.
The study findings were published in the peer reviewed International Journal of Translational Medicine.
https://www.mdpi.com/2673-8937/5/2/24
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Read Also:
https://www.thailandmedical.news/news/covid-19-induced-anti-ganglioside-autoantibodies-is-causing-neuropathy-in-many
https://www.thailandmedical.news/news/small-fiber-neuropathy-in-long-covid-and-chronic-fatigue-syndrome
https://www.thailandmedical.news/news/internal-tremor-in-long-covid-could-be-linked-to-dysautonomia-and-small-fiber-neuropathy
https://www.thailandmedical.news/articles/coronavirus
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