Causes of Tingling and Numbness – Paresthesia

What Does Tingling, Numbness and Paresthesia Mean?

Paresthesia (Greek para- = abnormal, esthesia = feeling) is abnormal sensation on the skin that has no apparent physical cause (1). Paresthesia includes numbness and tingling, and can be temporary or permanent.

Numbness is a decreased or lost sensation in the skin. Tingling is an unusual sensation in the skin. It is often described as feeling of pins and needles, tickling, pricking, creeping, skin crawling, ant crawling, and so on.

In certain disorders, like restless leg syndrome, tingling, numbness, burning, itchiness and pain may appear simultaneously.

Paresthesia can appear in any part of the body: in the trunk, limbs, fingers, toes, face or head.

Paresthesia and Dermatomes

Sensations are felt and interpreted by the brain. Sensibility of the trunk, limbs and the back of the head is mediated by the spinal nerves, arising from the spinal cord, and sensitivity of the face by Trigeminal nerve (5th cranial nerve), arising from the brainstem. The skin area innervated by a single nerve root of the spinal or Trigeminal nerve is called a dermatome (Latin derma = skin, tome = section), (Picture 1). From the distribution of abnormal skin sensations among dermatomes, a doctor can determine which nerves are affected.

Dermatomes of Human Skin

Picture 1. Dermatomes in a human

Symptoms of Paresthesia

Paresthesia appears without warning, is usually painless, and can be felt as tingling or numbness. Sensitivity of the affected skin part can be increased, but it is usually decreased. Other symptoms, like pain, muscular weakness, cramps, abnormal reflexes, warmth or cool feeling, paleness, redness, swelling or rash may be present, depending on the nature of an underlying disease.

Tingling is sometimes incorrectly described as itchiness. Itchiness provokes desire to scratch, while tingling does not. Burning  is also not the same as tingling, but rather a form of pain.

We often say our arm or leg has fallen asleep, when it becomes temporarily paralysed and numb.

How Does Paresthesia Occur?

Sensations from the skin are carried from the skin via peripheral sensory nerves through the spinal cord, or via Trigeminal nerve and brain stem to the brain. Disorder at any level of these neural pathways can cause paresthesia.

Causes of Transient Paresthesia

Transient paresthesia, lasting from few seconds to several minutes, often described as feeling of ‘pins and needles’, may be due to:

  • Obdormition – numbness caused by prolonged pressure on the nerve, like when you cross your legs and leg falls asleep. Such paresthesia disappears gradually as the pressure is relieved.
  • Whiplash
  • Hyperventilation syndrome
  • Panic attack
  • Dehydration
  • Transient ischemic attack (TIA), sometimes referred as “mini stroke”
  • Beta-alanine ingestion
  • Seizures
  • Raynaud phenomenon
  • Insufficient blood supply in atherosclerotic arteries in the legs (in Burger disease, paresthesia is accompanied with calf pain)

Causes of Chronic Paresthesia

Long lasting or recurring paresthesia can arise from:

  • Brain, spinal cord or peripheral nerve disorders: trauma, stroke, intra-cerebral hemorrhage, multiple sclerosis, tumors, encephalitis, meningitis, herniated disc, cervical spondylosis, pressure on the nerve (carpal tunnel syndrome, sciatica), repetitive motion or prolonged vibration, neuralgia
  • Circulatory (heart and vessels) disorders: angina pectoris, atherosclerosis, acute arterial occlusion, vasculitis, Raynaud disease, vertebrobasilar circulatory disorders
  • Metabolic and hormonal disorders: diabetes, low blood sugar (hypoglycemia), hypothyroidism, hypoparathyroidism, hypoaldosteronism (Conn syndrome), menopause, abnormal blood levels of calcium, potassium or sodium, uremia, porphyria
  • Infections and post-infection syndromes: infection with Herpes simplex virus, Herpes zoster virus, arbovirus; canker sores, Lyme disease, AIDS (HIV), leprosy, Guillain-Barré syndrome, rabies, syphilis
  • Connective tissue and autoimmune diseases: rheumatoid arthritis, systemic lupus erythematosus (SLE), Sjögren’s syndrome, pernicious anemia, diabetes
  • Blood disorders: thrombosis, polycythemia, thrombocytosis, leukemia
  • Bones and joints disorders: arthritis, osteomalacia, osteoporosis
  • Fibromyalgia
  • Nutrient deficiency: vitamin B1 deficiency (beriberi), vitamin B5 and B12 deficiency
  • Malignancies
  • Skin disorders: burns, frostbite, Ito syndrome, acrodynia, acroparesthesia
  • Migraine
  • Psychological disorders: anxiety, panic attack, psychiatric disease
  • Medications: anti-convulsant drugs, lomotil, SSRI withdrawal, amiodarone, colistimethate, digoxin, dimercaprol, mefloquine, riluzole , tetrodotoxin, thallium, topiramate, overdose of lidocain or vit B6
  • Alcohol, tobacco, illegal drugs
  • Poisoning: heavy metals (arzenic, lead, mercury), long term exposure to nitrous oxide, carbon monoxide, ciguatera poisoning, snake bites
  • Radiation exposure, chemotherapy
  • Hereditary diseases: Refsum syndrome, Fabry disease, Charcot-Marie-Tooth disease (a hereditary disorder that causes wasting of the leg muscles), porphyria, Denny-Brown’s syndrome (a hereditary disorder of the nerve root), ataxia-teleangiectasia
  • Immune deficiency

Diagnosis of the Cause of Paresthesia

1. Before appointment with your doctor, answer the following questions:

  • On which parts of your body do you feel tingling or numbness,  and is it limited to one side of the body (left or right)? How would you describe the felling: like numbness, loss of sensation, pricking, creeping, burning, itching, pins and needles…?
  • When did unusual sensation appear, is it permanent or transient? Does sensation change throughout the day?
  • What triggers the sensation: warmth, exercise, sitting, stress, food, medications…?
  • Other symptoms in the affected body part: pain, paleness, redness, swelling, warmth, coolness, cramps, loss of muscular power?
  • Any other general symptoms, like fever or headache?
  • Do you have any chronic disease, like diabetes or rheumatoid arthritis? Were you injured or admitted to the hospital in the past from some reason? Which diagnose(s) you have or had so far?
  • Does your work require repetitive motion, are you affected by constant vibrations, or exposed to certain chemicals like nitrogen oxide or carbon monoxide?
  • Are you under stress, are you anxious?
  • What is your diet, do you drink alcohol or smoke, which medications or drugs are you taking?

2. Doctor will examine you, what includes detailed neurological examination.

3. Doctor may order the following tests:

  • MRI or CT of the head and/or spine
  • MRI, CT or X-ray of the chest, abdomen, bones or joints
  • Blood tests: CBC, sedimentation rate, electrolytes, vitamins, sugar, sedimentation rate (ESR), proteins, thyroid hormones, heavy metals, drugs, antibodies to certain microbes, etc.
  • Urine tests: glucose, proteins, etc.
  • Electromyography (EMG), nerve conduction tests
  • Lumbar puncture (only when central nervous system disorders, like multiple sclerosis or meningitis, are suspected)
  • Vascular ultrasound and a cold stimulation test to check for Raynaud’s phenomenon
  • Nerve biopsy (rarely)

Treatment of Paresthesia

Treatment of paresthesia depends on the cause. Paresthesia is usually treated by a neurologist.

Home Care

Numbness after prolonged sitting or uncomfortable body position usually goes away after restoring circulation by stretching or massaging the affected limb. If the underlying cause cannot be treated, aspirin or ibuprofen can be tried. In more difficult cases, low dose of antidepressant drugs, such as amitriptyline, are sometimes prescribed to alter body’s perception of pain. In severe cases, opiates, as codeine, can be prescribed (3).

In nutritional deficiency, supplements, like B complex vitamins, especially vitamin B 12, can be tried (3).

Alcohol should be avoided. Self-massage with aromatic oils or ointments containing capsaicin may give temporary relief. Wearing lose shoes, gloves and clothes may also be helpful (3).

Call Emergency if you:

  • Feel weak, walk difficulty, hardly move an arm, have problems with speech or vision
  • Can not control your bladder or bowel
  • Feel numbness after an injury
  • Have lost consciousness, even if only for a while

Call your Doctor if you:

  • Do not know what causes abnormal sensations
  • Find out that numbness worsen during walking (could be pinched sciatic nerve)
  • Have pain, cramps, dizziness
  • Are urinating more often (could be diabetes)
  • Developed a rash you can not explain

Prognosis of Paresthesia

There is no known long-term physical effect from paresthesia itself (2). A disorder causing paresthesia can lead to permanent nerve damage, so this is why you need to visit a doctor, when the cause is uncertain. Prognosis depends on the underlying cause.

Related Articles:

References:

  1. Paresthesia Definition (medterms.com)
  2. Causes of Paresthesia  (paresthesia.info)
  3. Treatment of paresthesia  (neurology.health-cares.net)
  4. Disorders of a Single Peripheral Nerve and Numbness  (merck.com)
  5. Causes of Paresthesia (wrongdiagnosis.com)
  6. Diagnosis of Paresthesia  (wrongdiagnosis.com)
About Jan Modric (249 Articles)
Health writer
  • MELINDA

    Every time I try to slowly discontinue my Effexor XR I end up getting “brain zaps” and shock-like sensations all over my body. Is there anything that can help for these side effects when discontinuing the Effexor? Please help!

  • Jan Modric

    MELINDA,

    you can search online for “effexor withdrawal” to see that others also have these side effects after stopping the drug. I recommend you to speak with your doctor how exactly to reduce the dose or whatever else needs to be done. I can’t provide any reliable answer from here.

  • Sandesh

    I went on a hike with a 11kg pack. The weight of the pack was incorrectly balanced; the right side was heavier. Afterwards, I lost feeling in both arms and had difficulty raising them above my head. Though the feeling in my arm increased after a couple of days, it is still weak, stiff, slow to bend and has reduced feeling from the shoulder to elbow a week later. My wrist bends awkwardly sometimes too. The teacher said I had too much pressure on an artery,
    I went to the doctor 4 days after the injury and he said it was probably a torn ligament or pulled muscle, but it doesn’t seem right to me. Could you help me out? Thanks.

  • Jan Modric

    Sandesh,

    an orthopedist can examine you and tell what is the possible cause. It could be some trapped nerve in the armpit, for example.

  • heb331

    i am a 33 yr old female who for the last 6 months have had terrible lower back pain (have had this for over a yr), tingling & weak feeling in legs & feet, pain in ankles, and tight band feeling across abdomen. MRIs, xrays, lp all fine. ana b postive blood test. doctors have no diagnosis.

  • Jan Modric

    heb331,

    ANA antibodies speak for some rheumatic disorder (rheumatoid arthritis, SLE, Sjogren syndrome, systemic sclerosis). If you can provide the exact name of the antibodies (and eventual doctor’s comment), I can maybe narrow down the possibilities. A rheumatic disorder can cause arthritis in the spine resulting in pinched nerves that supply the trunk and legs. Joints in the leg can be also affected by arthritis. A rheumatologist could give you a diagnosis.

  • mrir

    i am 32 female ,post delivery .baby lost because gestational bp .after 1 month i have been crambing on my back head,here and there .some times more can not work that time .bp ok now.now i am little released that terrible stress. even though i have itching,numbness,paining and burning .sleep is more than before. slight swelling on the left wrist .kinly answer this problem

  • Jan Modric

    mrir,

    where do you feel itch, pain, burning and numbness? Are symptoms constant or are triggered or relieved by something?

  • ashlee

    hi, i have been on nuvaring for 9 months now, i had two different episodes one in april and one in june when i had my 1st side effect of nuva being that i had an aura(migraine). i haven’t had any other side effects up until last week when i started to get a numbness feeling in my right arm, mainly from my hand into my wrist and into my elbow. i’ve done some research on websites saying that it could be a side effect of the nuvaring, but it could also be carpal tunnel. i work at a pharmacy and do repetetive movements with both my right and left hand. i am left handed. i also sleep on my right side of body and my right arm usually goes numb every night. i try to reposition, but prefer sleeping on my right side. i am going to talk with my b.c doctor/nurse and see if she thinks its due to the nuvaring, or if it could be a pinched nerve. i am curious and a worried as well.

  • Jan Modric

    ashlee,

    it’s possible that NuvaRing has either caused the tingling or aggravated symptoms of eventual preexisting condition in your wrist or cervical spine (from where the nerves for the arms arise.

  • Openrev2

    I’ve been experiencing some strange burning and tingling in my face arms and legs for the past 2 years now it really hurts. sometimes i feel very cold and sometimes very hot and experience a lot of back back pain. Dont have a neurologist in my country. have done a lot of test which proved negative very confused dont know what to do someone please advice.

  • Jan Modric

    Openrev,

    it’s important you write down all your symptoms, do they appear on one or both sides of the body, eventual symptoms triggers or relievers and any other relevant circumstances, since this can help the doctor to narrow down possible causes. I agree that a neurologist may be an appropriate doctor to examine you.

  • sudhakar

    I feel burning sensation in my skin portions of abdomen,chest,armpits from two months after recovering from dengue fever.i also feel numbness & quick dizziness,insect crawling in backside of my head.please someone advise what is my condition.

  • Jan Modric

    sudhakar,

    I recommend you to visit a neurologist or the doctor who gave you a diagnosis of dengue fever. What you’ve described are neurological symptoms – the nerves, spinal cord or brain can be affected.

  • Saurabh

    Hi,

    I’ve been experiencing tingling on my arms and legs and also burning sensations on the palm of my hands. I am also suffering from pain in my right leg from last week or so, which worsens while walking and gets better when I rest. Could you please suggest any medicine for this pain.

  • Jan Modric

    Saurabh,

    a spinal disorder or a vessel or blood disorder could cause symptoms you’ve mentioned, but it is your primary doctor who can examine you and decide if you need to be checked by a specialist. Because I’m not sure about the cause of your pan, I don’t dare to recommend you any medication.

  • joyellen

    Jan when I wake up sometimes at night and I am laying on my back I feel numbness and tingling in my upper body.This goes away when I get out of bed. Do you have any idea what could be causing this.I am a 52 year old female in fair health.

  • Jan Modric

    joyellen,

    symptoms in arms due to a cervical spine disorder, like a bulging disc, can worsen at night. A neurologist or orthopedist can give an exact diagnosis; maybe a CT or MRI of the spine will be needed.

  • M. Tahir

    My wife is suffering from undefine health problem, Imbalance in walking, thing that she will fall, moving pain in all over head, neck muscle spasm, trinking in arms and hands when she is going to bed,
    MRI test is clear, and all other test even ear test is clear. but she feels contineously pressure in her head. can you help me in this regards,

    Thanks and best regards,

  • Dr. Chris

    Hi M.Tahir

    Even though the MRI is clear, this does not rule out many possibilities. Your wife needs to see a neurologist immediately. While the possibility of a stroke or TIA (transient ischemic attack which precedes a stroke) is a concern here, there is also a possibility that this is the start of a neurodegenerative condition. Another possibility is that severe muscle spasm, possibly compounded by other causes of nerve root compression may be causing many of these symptoms. Your wife’s doctor will assess here and try to exclude the most likely cause based on her current health status, medical history and so on. It is however important to consult with a neurologist at this stage.

  • enas

    hello
    since 3 days my mother develops sensation of numbness and tingling in her feet with feeling of swelling as well
    this is associated with feeling of pain of whole arms starting from the shoulders to the fingers with feeling of numbness as well
    these episodes start at evening and she became fine in the morning
    she is not hypertensive not diabetic
    she is above 40 years (menopause)

  • caroline

    In November 06 l had an op to remove the ducts from my right breast due to numerous absesses.Since then i have been troubled by left arm parathesia sevier chest pain carpo pedal spasms spasms all over my body it has shown on xrays that my nech muscles also spasm nurologist also mentioned restless leg syndrome hemicranialigraines my neck left si#de of neck burns this week went to gp i couldent move my head from left to right without pain shooting from left side of neck down my shoulder he said that i have a trapped nerve i have had all test nerve conduction and bloods done all good alldr say its stress im confused please help

  • shad

    hi, I have tingling in my body, it starts 2 days a go. It was only on my left hand but now it’s on my left part of my body , but not on my legs. only arm, chest, back and abdominal.
    what could it be? what’s cuses it ?
    I went to the GB yesterday, she only give me a pain releve ( nurofen )
    do I need to do anything ? do i need to something like x-ray or so ?
    Thank you

  • Dr. Chris

    Hi Enas

    Being in her 40s and menopausal does put her at risk of various cardiovascular diseases that could account for these symptoms. She may be experiencing venous insufficiency which is a problem with the veins in the legs or this peripheral edema could be a sign of heart problems. The problems with her upper limbs may or may not be related. If your mother is overweight, the risks of what I just discussed is greatly increased. She needs to see a doctor as this could be the early signs of more serious conditions – like a stroke or heart failure.

  • M. Tahir

    Thank you very much respected Dr. chris, Now with other symtoms, she feel weakness specially in her legs and continuously embalance in walking, and fear of falling in walking as feels dissiness in walking as well as in lying position. Also she can not able to hears the telephone call after 2 or 3 minutes,

  • Dr. Chris

    M.Tahir

    She needs to see a doctor immediately. I don’t think this is the platform to answer these question and trying to seek answers online is wasting time and probably putting her life and well being at risk.

  • candace m.

    Hi. I am an 18 year old female experiencing numbness and SOME “creepy crawly-ness” all over.Absolutely everywhere.

    Face, hands, arms, legs, feet, head.

    I’m otherwise completely healthy and have had no medical complications ever.

    Help?

  • Dr. Chris

    Hi Shad

    As you can see in the article above, there are many possible causes. A lot depends on you age, medical history, current health status and so on. It could be the first symptoms of a heart problem, stroke and so on. However, you don’t report other symptoms. It could even be related to nerves supplying this area stemming from an impingement in the neck or along its course. What is of concern though is that the extent of the area is spreading. Certain viral infections of the nerve can causes these symptoms so also take note of muscle weakness in these areas. Intracranial (within the part of the skull where the brain sits) tumors, abscesses and other growths and even raised intracranial pressure may also be causing these symptoms. Go back to your GP and report the fact that symptoms are spreading. Further investigation may be warranted and even a referral to a neurologist.

  • Jamie

    I have a history of fabrys disease in my family. My older sister had kidney failure and a transplant at 21 years old. I’m currently 24, and I’ve been experiencing numbness in my right calve periodically, usually expanding over several days. I also have excessive sweating, and a low tolerance for temperature changes. A few years ago I had an ultrasound of my kidneys and everything was normal except I have one kidney larger than the other. I am a recent graduate and currently not working, therefore I don’t have a job where I’m doing repetitive motions, and I exercise 5 times a week.