Tingling and Pins and Needles: Paresthesia and its Symptoms

“Individuals feeling tingling or pins and needles sensations that overtake the arms or legs could be experiencing paresthesia, which occurs when a nerve has been compressed or damaged. Can knowing the symptoms and causes help in diagnosis and treatment?”

Paresthesia Body Sensations

The numbness or tingling feeling when an arm, leg, or foot has fallen asleep is not so much about blood circulation but nerve function.

• Paresthesia is an abnormal sensation felt in the body due to the compression or irritation of nerves.
• It can be a mechanical cause like a compressed/pinched nerve.
• Or it may be due to a medical condition, injury, or illness.

Symptoms

Paresthesia can cause various symptoms. These symptoms can range from mild to severe and can be brief or long-lasting. Signs can include: (National Institute of Neurological Disorders and Stroke. 2023)

• Tingling
• Pins and needles sensations
• Feeling like the arm or leg has fallen asleep.
• Numbness
• Itching.
• Burning sensations.
• Difficulty contracting the muscles.
• Difficulty using the affected arm or leg.

1. The symptoms typically last for 30 minutes or less.
2. Shaking the affected limb often relieves the sensations.
3. Paresthesia usually affects only one arm or leg at a time.
4. However, both arms and legs can be affected, depending on the cause.

Consult a healthcare provider if the symptoms last for more than 30 minutes. Treatment may be required if paresthesia body sensations are brought on by a serious underlying cause.

Causes

Sitting with incorrect and unhealthy postures can compress a nerve and generate symptoms. However, some causes are more concerning and can include:

• Central nervous system conditions – stroke or multiple sclerosis/MS. (National Institute of Neurological Disorders and Stroke. 2023)
• Altered nerve function brought on by a condition, like diabetes.
• Compression or irritation of spinal nerve/s. (American Association of Neurological Surgeons. 2023)
• Tension and traction or pulling on a nerve.

Seeking Medical Assistance

If the symptoms don’t go away after 30 minutes or keep returning for unknown reasons, call a healthcare provider to find out what is causing the abnormal sensations. A worsening case should be monitored by a healthcare provider.

• Peripheral neuropathy caused by diabetes usually begins with a feeling of paresthesia in the foot/feet and can worsen and lead to other complications.
• This is a symptom that diabetes is poorly controlled and needs to be managed appropriately. (National Institute of Diabetes and Digestive and Kidney Diseases. 2018)

Diagnosis

A healthcare provider will work with the individual to understand the symptoms and perform the appropriate diagnostic tests to determine the cause. A healthcare provider will choose the tests based on a physical examination. Common diagnostic procedures include: (Merck Manual Professional Version. 2022)

• Magnetic resonance imaging – MRI of the spine, brain, or extremities.
• X-ray to rule out bone abnormalities, like a fracture.
• Blood tests.
• Electromyography – EMG studies.
• Nerve conduction velocity – NCV test.

1. If paresthesia is accompanied by back or neck pain, a healthcare provider may suspect a compressed/pinched spinal nerve.
2. If the individual has a history of diabetes that is poorly controlled, they may suspect peripheral neuropathy.

Treatment

Treatment for paresthesia depends on the diagnosis. A healthcare provider can help determine the best course of action for the specific condition.

Nervous System

• If symptoms are triggered by a central nervous condition like MS, individuals will work closely with their healthcare provider to get the appropriate treatment.
• Physical therapy could be recommended to help improve overall functional mobility. (Nazanin Razazian, et al., 2016)

Spinal Nerve

• If paresthesia is caused by compression of a spinal nerve, like sciatica, individuals may be referred to a chiropractor and physical therapy team to release the nerve and pressure. (Julie M. Fritz, et al., 2021)
• A physical therapist may prescribe spinal exercises to relieve compression of the nerve and restore normal sensations and motion.
• Strengthening exercises to restore flexibility and mobility may be prescribed if weakness presents along with paresthesia body sensations.

Herniated Disc

• If a herniated disc is causing the abnormal sensations, and there has been no improvement with conservative measures, a healthcare provider may suggest surgery to relieve pressure on the nerve/s. (American Association of Neurological Surgeons. 2023)
• In surgical procedures like a laminectomy or discectomy, the objective is to restore nerve function.
• Post-surgery, individuals may be recommended to a physical therapist to help regain mobility.

Peripheral Neuropathy

• If peripheral neuropathy from diabetes is the cause, the symptoms can become permanent and may change slightly with medication. (National Institute of Diabetes and Digestive and Kidney Diseases. 2018)

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References

National Institute of Neurological Disorders and Stroke. (2023) Paresthesia.

American Association of Neurological Surgeons. (2023) Herniated disc.

National Institute of Diabetes and Digestive and Kidney Diseases. (2018) Peripheral neuropathy.

Merck Manual Professional Version. (2022) Numbness.

Razazian, N., Yavari, Z., Farnia, V., Azizi, A., Kordavani, L., Bahmani, D. S., Holsboer-Trachsler, E., & Brand, S. (2016). Exercising Impacts on Fatigue, Depression, and Paresthesia in Female Patients with Multiple Sclerosis. Medicine and science in sports and exercise, 48(5), 796–803. https://doi.org/10.1249/MSS.0000000000000834

Fritz, J. M., Lane, E., McFadden, M., Brennan, G., Magel, J. S., Thackeray, A., Minick, K., Meier, W., & Greene, T. (2021). Physical Therapy Referral From Primary Care for Acute Back Pain With Sciatica : A Randomized Controlled Trial. Annals of internal medicine, 174(1), 8–17. https://doi.org/10.7326/M20-4187