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Pins and Needles in Hands or Feet

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Pins and Needles in Hands or Feet

Have you ever crossed your legs and then, when you uncross them, your legs feel tingly? Or have you fallen asleep on your arm, only to have it go numb and then feel a “pins and needles” sensation? This tingling, burning, or prickling feeling is called paresthesia, according to the National Institute of Neurological Disorders and Stroke. Paresthesia can be temporary (like when you sleep on your arm) or chronic, which can indicate an underlying condition. Learn more about paresthesia and common causes.

What is paresthesia?

Paresthesia is the formal name for a numb, burning, or prickly feeling that most often occurs in the hands, arms, legs, or feet, although it can occur in other parts of the body. It can be accompanied by pain or weakness, too.

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What are paresthesia symptoms?

  • Tingling
  • Pins and needles
  • Prickling
  • Numbness
  • Itching
  • Burning

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What causes paresthesia?

There are two types of paresthesia, temporary and chronic.

Temporary paresthesia

Temporary, or episodic paresthesia causes include:

  • Pinched nerve
  • Whiplash
  • Bone fractures
  • Dehydration
  • Seizures
  • Hyperventilation
  • Panic attacks
  • Pregnancy

A pinched nerve results from too much pressure on a nerve. Injury, repetitive motions, and inflammatory conditions can cause a pinched nerve. Carpal tunnel is a common cause of paresthesia; this happens when the median nerve in the wrist becomes compressed, leading to numbness or tingling in the fingers. Standing for too long, crossing your legs for too long, or lying on your hands or feet also put pressure on nerve, leading to paresthesia. Once the pressure goes away, the paresthesia goes away, too.

Whiplash is an injury in the neck due to a rapid forward and backward movement of the head and neck. Whiplash can cause nerves in the neck to become compressed or inflamed, causing tingling, numbness, or weakness that radiates down the shoulder, arms, hands and/or fingers.

Pregnancy can lead to paresthesia, too This happens because, as the baby grows, the uterus presses on the nerves in the legs, causing pins and needles in the legs and toes. This is normal and goes away after the baby is born.

Chronic paresthesia

Chronic paresthesia results from an underlying condition, including:

  • Diabetic neuropathy
  • Thyroid disorders
  • Vitamin deficiency
  • Accident or injury
  • Infection (e.g., Lyme disease, shingles)
  • Chronic kidney disease
  • Stroke
  • Multiple sclerosis
  • Autoimmune disease (e.g., lupus, rheumatoid arthritis)
  • Transverse myelitis
  • Encephalitis
  • Brain tumor
  • Osteoporosis
  • Certain medications (e.g., chemotherapy, some antibiotics, HIV medications, some seizure medications)
  • Heavy metal poisoning
  • Alcoholism

People with type 1 or type 2 diabetes are at risk of diabetic neuropathy, which occurs due to damage to nerves from long-term high blood sugars. Paresthesia is a common symptom of diabetic neuropathy, and accounts for the prickling, tingling, and numbness that are characteristic of this complication.

Chronic kidney disease, another complication related to diabetes, can also lead to nerve damage, possibly due to nutrient deficiencies, dialysis, and high phosphorous levels.

Untreated hypothyroidism, a condition in which the thyroid gland doesn’t make enough thyroid hormone, can lead to fluid buildup, which puts pressure on the nerves in the arms and legs.

A vitamin B12 deficiency, which can result from taking the diabetes medicine metformin for a long time, is another cause of paresthesia. Vitamin B12 is necessary for proper nerve function.

How is paresthesia diagnosed?

The occasional paresthesia that results from sitting funny on your legs or falling asleep on your arm is most likely not a cause for concern. However, if you have frequent symptoms of paresthesia (meaning, pins and needles or numbness), talk with your health care provider about your symptoms. Your provider will review your symptoms and your medical history and likely do a physical exam. He or she may order certain tests, such as:

  • Blood tests
  • Nerve conduction study
  • Electromyography (EMG)
  • MRI
  • Ultrasound
  • CT scan

The type of tests ordered are based on your provider’s findings and suspicions as to the cause of your paresthesia.

How is paresthesia treated?

Again, the treatment of paresthesia is based on the cause. Treatment may include:

  • A brace or a split
  • Physical therapy
  • Immobilization
  • Medications to relieve pain, swelling, and inflammation
  • Vitamin supplementation to correct a deficiency
  • Lifestyle changes: healthy eating, exercise, foot care, reduced alcohol intake
  • Surgery to relieve pressure on a pinched nerve

Want to learn more about neuropathy? Read “Coping With Painful Neuropathy,” “Diabetic Peripheral Neuropathy,” and “Controlling Neuropathic Pain.”

Amy Campbell, MS, RD, LDN, CDCES

Amy Campbell, MS, RD, LDN, CDCES

Amy Campbell, MS, RD, LDN, CDCES on social media

A Registered Dietitian and Certified Diabetes Educator at Good Measures, LLC, where she is a CDE manager for a virtual diabetes program. Campbell is the author of Staying Healthy with Diabetes: Nutrition & Meal Planning, a co-author of 16 Myths of a Diabetic Diet, and has written for  publications including Diabetes Self-Management, Diabetes Spectrum, Clinical Diabetes, the Diabetes Research & Wellness Foundation’s newsletter, DiabeticConnect.com, and CDiabetes.com

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