ANS Testing

An Autonomic Nerve Study (ANS) test is a diagnostic tool to detect small fiber neuropathy (SFN). Results of ANS testing may help form a diagnosis or guide treatment.

Common ANS Diagnoses

Small fiber neuropathy is a common disorder linked to several rheumatic conditions.


Chronic Inflammation

What is Small Fiber Neuropathy (SFN)?

Small fiber neuropathy is a disorder of the peripheral nervous system. Damage to the nerves in your skin can cause a “pins and needles” sensation, numbness, or burning. Symptoms are most often felt in the hands and feet. They may come on suddenly at random, but may also worsen over time.

Why ANS Testing?

Small fiber neuropathy (SFN) is common in several rheumatic diseases and can significantly affect quality of life. ANS testing helps identify moderate to severe SFN and help to form a treatment plan.

ANS Testing Process

An ANS test consists of 4 non-invasive tests that measure your heart rate and blood pressure. AN ANS test can be performed by your rheumatologist at the clinic.

  • Resting heart rate, blood pressure & pulse (arterial) waveform
  • Valsalva Maneuver
  • Deep breathing
  • Response to postural change (sitting to standing)

Forming a Diagnosis

If an ANS test indicates mild, moderate, or severe neuropathy, a follow-up cutaneous nerve biopsy (Punch Biopsy) is conducted for confirmation. A punch biopsy collects a small piece of skin tissue that is evaluated under a microscope.

Who May Require an ANS Test?

  • New patients with a rheumatology diagnosis
  • Established patients with therapy changes
  • Patients not responding to therapy
  • Patients needing complementary therapy for remission or low disease activity


If you have more questions about ANS testing, please ask your rheumatologist at your next visit or send our team a message. 

Oklahoma Contact Information


Edmond: (405) 260-8605


(405) 369-9310

Arizona Contact Information


Gilbert: (480) 494-2770
Casa Grande: (520) 557-5660


(480) 494-2771

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