Paresthesia can be defined as strange skin sensation that causes tingling or pricking sensation. It is also called as “pins and needles” in colloquial terms or falling asleep of the limbs for few minutes. It is a painless feeling and this abnormal sensation is felt in the hands, feet or legs and arms. The term Paresthesia originates from the Greek in which “para” means abnormal indicating abnormal sensation. For some people this feeling is described as burning, pricking or tingling sensation and for others it is felt as numbness.
Paresthesia occurs suddenly without any warning and often it is short-term. Paresthesia is caused due to several reasons including neurological and orthopedic problems and for some people it is caused when excess of pressure is applied on the nerve. This phenomenon can be acute (short-term) for many people and it can be chronic (long-term) for some people. This type of strange feeling is actually a symptom of underlying medical condition. Treatments can be given based on the root cause of paresthesia.
Paresthesia is of two types namely temporary or acute and chronic or long term.
- Acute Paresthesia – As the name indicates the feeling of ‘pins and needles’ are short-lived and temporary. A person who has fallen asleep on his arm would experience the feeling of numbness or prickling for few minutes. This can be caused due to exerted pressure on the arm by the skull. This feeling would disappear once the pressure is relieved.
- Chronic Paresthesia – In this case abnormal sensation is felt frequently and this occurs due to medical conditions like neurological or orthopedic problem. Severe disorders like multiple sclerosis, strokes or any serious problem in the central nervous system can induce tingling feeling in the arms and hands. Growing tumor in the brain or spinal cord can exert pressure on the surrounding regions causing this strange feeling. In some cases underlying nerves get entrapped like in the case of carpal tunnel syndrome.
Causes of Paresthesia :
Paresthesia (tingling sensation) can be caused by mild factors like built-up pressure to more serious causes like multiple sclerosis or brain tumor. Wide range of potential causes of Paresthesia include orthopedic factors like degenerative disk disease, herniated disk, osteoporosis, bone fractures and entrapment of nerves. Neurological causes of Paresthesia include formation of tumor (in the brain or spine), encephalitis, neuritis, infectious diseases like Lyme disease or frostbite, nerve damage caused by prolonged pressure, autoimmune disorders like Lupus or multiple sclerosis, strokes like transient ischemic attack and peripheral neuropathy and heavy metal poisoning like lead/mercury and migraine.
Paresthesia can be caused by drug-related problems like intake of Beta-blockers, benzodiazepine withdrawal, certain types of anticonvulsant drugs and withdrawal of medications belonging to SSRI group. The symptoms of tingling and numbness can also be caused by cardiovascular problems like poor circulation, atherosclerosis, and peripheral vascular diseases. In some cases, certain types of metabolic disorders like dehydration, hyperkalemia, diabetes, hypothyroidism and high levels of magnesium in blood can cause this problem. For some patients, anesthesia can be a cause of paresthesia. Contaminated sterile solutions, damage of nerve sheath fiber due to anesthesia can cause the effect of Paresthesia. Sometimes, Paresthesia can be indicative of underlying medical disorders like muscular atrophy, numbness, restless leg syndrome, dysarthria and crawling feeling on the skin.
Symptoms Of Paresthesia :
Well defined symptoms of Paresthesia include tingling sensation, numbness, pricking or burning feeling. Some people would have these abnormal sensations with pain also. Often these symptoms target the extremities of the body like fingers/toes and hands/legs. There are people who report about itching sensation with burning pain due to this problem. In rare cases Paresthesia can be accompanied with serious signs like loss of consciousness, dizziness, changes in visual perception, shortness of breath, slurred speech and difficulty in walking. In that case the person should be treated on emergency basis to prevent fatal issues.
When To Check With Your GP :
If you have occasional symptoms of Paresthesia while falling asleep on your arm you can ignore it. But if the symptoms of numbness and tingling sensation occur repeatedly with or without other symptoms you need to consult your doctor. Patients with previous medical problems like diabetes and neurological issues should give top priority to these symptoms.
Your doctor will collect complete medical history before attempting to diagnose Paresthesia. He/she would check whether it is accompanied with other symptoms. He may order for test based on your symptoms. Nerve conductivity test would be administered if the doctor suspects any neurological problem or nerve damage. Other laboratory test would be ordered for checking the rate of metabolism of the person.
Treatment of Paresthesia :
Method of treatment depends on underlying medical condition. Firstly the doctor would make sure of the underlying reason for Paresthesia. Stretching exercises and gentle massaging of the affected limb can improve the symptoms and give relief from temporary numbness. Pain-killers like Ibuprofen is recommended for quick relief from mild pain. Chronic form of Paresthesia can be treated with mild antidepressant drugs. Usually the doctor would start with mild dosage and observe the progress of the symptoms and gradually increase the dose depending on the situation. Drugs like amitriptyline would reduce the signals of pain perception in the brain thereby providing relief of the above symptoms.
In case the doctor suspects deficiency of nutrients like vitamins he may prescribe supplementary vitamins like vitamin B12 in the form of injection or pills. Alternative treatments are available for Paresthesia in the form of acupuncture. Massage with aromatic oils can also give relief from the symptoms. For people who get symptoms of Paresthesia due to cardiovascular problems blood pressure and cholesterol level would be stabilized by giving suitable medications.
For those who are long-term diabetic blood sugar levels should be regularly monitored to prevent diabetic neuropathy. Patients who are immune-compromised would be given prednisone or suitable corticosteroids and in some cases intravenous gamma globulin is given. Topical creams like Lidocaine or Prilocaine can help in relieving the signs of temporary tingling and numbness. In very rare cases, surgical interventions is necessary to relieve the pressure from the underlying nerve.
Useful Tips :
The affected person should wear loose fitting clothes and shoes to reduce the intensity of symptoms. He/she should take a healthy diet and do regular exercise to reduce stress.
Often, Paresthesia symptoms can improve if the underlying cause is diagnosed and treated. It might take enough time if the case is chronic and due to severe underlying medical conditions like tumor or multiple sclerosis.