Paresthesia If you’ve ever felt as though your skin was crawling, or had numbness or itching for no apparent reason, you may have experienced paresthesia. Almost everyone has experienced paresthesia on occasion. One of the most common times people get that familiar feeling of pins and needles is when their arms or legs “fall asleep.” This sensation usually occurs because you’ve inadvertently put pressure on a nerve. It resolves once you change your position to remove the pressure from the affected nerve. This type of paresthesia is temporary and usually resolves without treatment. If the paresthesia persists, you may have an underlying medical disorder that requires treatment.

What are the symptoms of paresthesia? Paresthesia can affect any part of the body, but it commonly affects the: hands

arms

legs

feet It can be temporary or chronic. The symptoms can include feelings of: numbness

weakness

tingling

burning

cold Chronic paresthesia may cause a stabbing pain. That may lead to clumsiness of the affected limb. When paresthesia occurs in your legs and feet, it can make it difficult to walk. See your doctor if you have symptoms of paresthesia that persist or affect with your quality of life. It could be a sign that you have an underlying medical condition that needs treatment.

What causes paresthesia? It’s not always possible to determine the cause of paresthesia. Temporary paresthesia is often due to pressure on a nerve or brief periods of poor circulation. This can happen when you fall asleep on your hand or sit with your legs crossed for too long. Chronic paresthesia may be a sign of nerve damage. Two types of nerve damage are radiculopathy and neuropathy. Radiculopathy Radiculopathy is a condition in which nerve roots become compressed, irritated, or inflamed. This can occur when you have: a herniated disk that presses on a nerve

a narrowing of the canal that transmits the nerve from your spinal cord to your extremity

any mass that compresses the nerve as it exits the spinal column Radiculopathy that affects your lower back is called lumbar radiculopathy. Lumbar radiculopathy can cause paresthesia in your leg or foot. In more severe cases, compression of the sciatic nerve can occur and may lead to weakness in your legs. The sciatic nerve is a large nerve that starts in your lower spinal cord. Cervical radiculopathy involves the nerves that provide sensation and strength to your arms. If you have cervical radiculopathy, you may experience: chronic neck pain

paresthesia of the upper extremities

arm weakness

hand weakness Neuropathy Neuropathy occurs due to chronic nerve damage. The most common cause of neuropathy is hyperglycemia, or high blood sugar. Other possible causes of neuropathy include: trauma

repetitive movement injuries

autoimmune diseases, such as rheumatoid arthritis

neurological diseases, such as MS

kidney diseases

liver diseases

stroke

tumors in the brain or near nerves

bone marrow or connective tissue disorders

hypothyroidism

deficiencies in vitamin B-1, B-6, B-12, E, or niacin

getting too much vitamin D

infections, such as Lyme disease, shingles, or HIV

certain medications, such as chemotherapy drugs

exposure to toxic substances, such as chemicals or heavy metals Nerve damage can eventually lead to permanent numbness or paralysis.

Who is at risk for paresthesia? Anyone can experience temporary paresthesia. Your risk of radiculopathy increases with age. You also may be more prone to it if you: perform repetitive movements that repeatedly compress your nerves, such as typing, playing an instrument, or playing a sport such as tennis

drink heavily and eat a poor diet that leads to vitamin deficiencies, specifically vitamin B-12 and folate

have type 1 or 2 diabetes

have an autoimmune condition

have a neurological condition, such as MS

How is paresthesia diagnosed? See your doctor if you have persistent paresthesia with no obvious cause. Be prepared to give your medical history. Mention any activities you participate in that involve repetitive movement. You should also list any over-the-counter or prescription medications that you take. Your doctor will consider your known health conditions to help them make a diagnosis. If you have diabetes, for example, your doctor will want to determine if you have nerve damage, or neuropathy. Your doctor will probably perform a full physical exam. This will likely include a neurological exam as well. Blood work and other laboratory tests, such as a spinal tap, may help them rule out certain diseases. If your doctor suspects there’s a problem with your neck or spine, they may recommend imaging tests, such as X-rays, CT scans, or MRI scans. Depending on the results, they may refer you to a specialist, such as a neurologist, orthopedist, or endocrinologist.

What is the treatment for paresthesia? Treatment depends on the cause of your paresthesia. It may be possible to treat your condition by eliminating the cause in some cases. For example, if you have a repetitive movement injury, a few lifestyle adjustments or physical therapy may solve the problem. If your paresthesia is due to an underlying disease, getting treatment for that disease can potentially ease the symptoms of paresthesia. Your individual circumstances will determine whether your symptoms will improve. Some types of nerve damage are irreversible.

What is the outlook for people with paresthesia? Temporary paresthesia usually resolves within a few minutes. You may have a case of chronic paresthesia if those strange sensations don’t go away or they come back far too often. It can complicate your daily life if the symptoms are severe. That’s why it’s so important to try to find the cause. Don’t hesitate to seek a second opinion or see a specialist if necessary. The severity of chronic paresthesia and how long it will last largely depends on the cause. In some cases, treating the underlying condition solves the problem. Be sure to tell your doctor if your treatment isn’t working so they can adjust your treatment plan.