The peripheral nervous system is divided into three systems-motor, sensory, and autonomic. In superficial siderosis, chronic peripheral neuropathic pain is the result of abnormal activity in sensory nerves. The sensory neurons are firing, but they send the wrong message of sensation without reason. A person can feel as they are being cut, stabbed, feelings of icy coldness or burning even though nothing is touching them.

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Signs and Symptoms

  • Burning sensation or freezing pain
  • Sharp, stinging or jolting pain
  • Skin Sensitivity
  • Difficulty sleeping because of pain
  • Trouble walking or moving the arms
  • Sweating out of the ordinary
  • Extreme weakness and loss of strength
  • Not being able to hold something
  • Not knowing where your feet are


Prescription Medications

Superficial Siderosis patients with small fiber neuropathy require chronic pain management. As your pain intensity progress, it no longer responds to acetaminophen or over-the-counter medications like other pain.  Also, it generally does not respond to stronger opioids. Neuropathic pain is treated with medications that will calm nerve overactivity. These medications may include anti-seizure medications and certain types of antidepressants like Pregabalin (Lyrica).

Herbal and Over-The Counter Options

A daily dose of 600 mg alpha-lipoic acid is an over-the-counter antioxidant often recommended in cases of diabetic peripheral neuropathy. To be effective in superficial siderosis It should be used as an enhancer in conjunction with other medications.

Yan Hu Suo Pian (Corydalis Relaxe) is a traditional Chinese herbal blend that has shown efficacy in controlling peripheral neuropathy pain in our personal experience. The formula is a proprietary blend containing: Rhizoma Corydalis yanhusuoRadix Angelicae DahuricaeRhizoma Cyperi Rotundi, and Rhizoma Ligustici Chuanxiong. Read The Neuropathy Chronicles to learn more.

Non-Pharmicalogic Options

  • Acupuncture
  • Meditation
  • Cognitive Behavioral Therapy

Before starting any treatment, prescription medication, herbal supplement, or over-the-counter option, please discuss it with your healthcare provider.

Updated: October 22, 2021

¹Cleve Clin J Med. 2009 May;76(5):297-305. doi: 10.3949/ccjm.76a.08070. Small fiber neuropathy: A burning problem. Tavee J, Zhou L.
²Lacomis D. Small fiber neuropathy. Muscle Nerve 2002; 26:173–188.
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