Where the testing is done
Measura
4477 Woodson Rd, Suite 201
St. Louis, MO 63134
Monday to Friday, 9:00 a.m. to 5:00 p.m.
From Bridgeton the suite is a short drive east, between Interstate 70 and Natural Bridge Road on Woodson Road, just south of Lambert International Airport. Parking is on site and level with the entrance.
How do you test for neuropathy when your feet are numb or burning?
This is the single most common reason Bridgeton patients are sent a few minutes down the road, and it is a question that objective testing answers better than examination alone.
A monofilament and a tuning fork test large-fiber function. They are quick, they are appropriate, and they are normal in a substantial share of people whose small fibers are already affected — which is where burning, temperature change and early autonomic symptoms come from.
Sudomotor testing measures sweat-gland response, which is a small-fiber function, so it can register change while the standard bedside tests are still reported as normal. That is the gap it exists to close. Peripheral neuropathy symptoms covers the presentation.
Is it poor circulation or neuropathy?
Leg symptoms get attributed to circulation by default. Sometimes that is right, and the distinction changes what should be done about it.
The ankle brachial index and pulse volume recording measure arterial supply directly. A normal result makes large-vessel disease unlikely and moves the question toward nerve. An abnormal one is a cardiovascular finding that matters well beyond the legs.
Running both in one sitting is the point: you leave knowing which of the two is driving the symptom, rather than treating one and hoping. Circulation and leg symptoms covers the separation.
Arriving unhurried is part of the protocol
Proximity matters more here than it sounds. Vascular and autonomic measurements are affected by exertion immediately beforehand — a brisk walk from a distant parking space is enough to move them, let alone a rushed drive.
A rest period precedes the measurements for that reason, and a short trip makes it easier to arrive in the state the protocol assumes. Parking is level with the entrance, which removes the last bit of exertion before you sit down.
Frequently asked questions
My monofilament test was normal. Why test further?
Because a monofilament tests large-fiber function. Burning, temperature change and early autonomic symptoms come from small fibers, which sudomotor testing measures directly.
Is this the same as a nerve conduction study?
No. Nerve conduction studies also assess large fibers. These measurements are complementary to that, not a substitute for it.
Do I need to fast?
For the full panel yes, because the laboratory and metabolic components require it. For a focused vascular and sudomotor visit, usually not.
How do doctors test for neuropathy in the feet?
Most people get a monofilament and a tuning fork. Both check large-fiber function, and both can read normal while the small fibers are already affected. Sudomotor testing measures sweat-gland response, which is a small-fiber function, so it can register change that the bedside tests miss. Here it runs in the same sitting as the ankle brachial index and pulse volume recording, which check blood supply to the legs.
What could be mistaken for neuropathy in the feet?
Poor circulation. Leg symptoms get blamed on circulation by default, and the two feel similar. The ankle brachial index and pulse volume recording measure arterial supply directly. A normal result makes large-vessel disease unlikely and moves the question toward the nerves. An abnormal result is a cardiovascular finding that matters well beyond the legs, so it is worth knowing either way.
What are the first signs of neuropathy in the feet?
Burning, changes in how your feet sense temperature, and early autonomic symptoms. All of them come from the small nerve fibers. Those fibers can already be affected while the large fibers that a monofilament or tuning fork checks still test normal. That is why your feet can feel wrong while the office exam is reported as fine, and why sudomotor testing is part of the workup.
Nearby communities
Medically reviewed by Dr. Gurpreet Singh Padda, MD, MBA, MHP, medical director of Measura. Last reviewed .