This presentation will review the causes and symptoms of small fiber neuropathy, a grossly underappreciated painful disorder that frequently is manifested by chronic widespread pain. Symptoms--burning and shooting pain, allodynia, and hyperesthesia--may result from myriad diseases, including diabetes, thyroid dysfunction, sarcoidosis, vitamin B12 deficiency, HIV, and neurotoxic medications, among others; however, often no specific cause is determined. In this course, emphasis will be placed on determining the underlying etiology so that treatment can be tailored as much as possible, including management of associated neuropathic pain.