Up to 60% of Fibromyalgia patients in some studies show evidence of Small Fiber Polyneuropathy (SFPN), a condition which shares many symptoms with Fibromyalgia and which may be treatable. Dr. Khosro Farhad spoke about this topic and reviewed recent research on SFPN at a public talk sponsored by the Massachusetts CFIDS/ME & FM Association on Nov. 14, 2015 at Newton-Wellesley Hospital, Newton, Massachusetts.

Disclaimer: There materials are provided only for convenience so that you can print them out and take them to discuss with your health care provider. 

Please note this correction from Dr. Farhad: "When I spoke about the diagnosis of fibromyalgia based on American College of Rheumatology criteria, there was a mistake in my explanation. The patients need to answer “yes” to the first question and “no” to the second question in the third box [questions 4 and 5, see slide 3]. I mentioned patients should answer yes to both questions, which is not correct."


Dr. Farhad has provided copies of the research articles that he mentioned in his talk.

Caro XJ et al, “Evidence of Abnormal Epidermal Nerve Fiber Density in Fibromyalgia, Clinical and Immunologic Implications,” Arthritis & Rheumatology: 66, No. 7 (July 2014): 1945–1954.

Kosmidis ML…Dalakas MC et al, Reduction of Intraepidermal Nerve Fiber Density (IENFD) in the skin biopsies of patients with fibromyalgia: A controlled study,” Journal of the Neurological Sciences 347 (2014): 143–147.

Giannoccaro MP et al, “Small Nerve Fiber Involvement In Patients Referred For Fibromyalgia,” Muscle Nerve 49 (2014): 757–759.

Oaklander AL, et al, “Objective evidence that small-fiber polyneuropathy underlies some illnesses currently labeled as fibromyalgia,” Pain 154, No. 11 (November 2013).

Oaklander AL, et al, “Evidence of Small-Fiber Polyneuropathy in Unexplained, Juvenile-Onset, Widespread Pain Syndromes,” Pediatrics 131 No. 4 (2013).

Uceyler N et al, “Small fibre pathology in patients with fibromyalgia syndrome,” Brain 136 (2013): 1857–1867.