What Is Paresthesia and What Causes It?

Paresthesia is a burning or tingling sensation that is typically occurs in the hands, arms, legs, or feet, but can also be felt in other parts of the body. A wide array of causes include seizures, circulatory disorders, infections, toxic exposure, diabetes and hyperthyroidism.

Paresthesia affects most people at some point in their lives. Most people have experienced a “pins and needles” feeling before. It most often occurs in the hands, feet, legs or arms but can affect other areas of the body.

Temporary paresthesia often results when a person falls asleep on their hand or sits with their legs crossed for too long. The sustained pressure on the nerve interferes with its ability to send signals, leading to the numb feeling associated with a limb “falling asleep."

When the block is removed, the nerve system becomes hyperactive as it is allowed to resume normal function, leading to the uncomfortable tingling.

Chronic paresthesia does not go away so easily. It is either constant or intermittent and usually arises from neuropathy, or nerve damage. Neuropathy can lead to muscle weakness as well as pain or numbness.

While the occasional “pins and needles” feeling should not concern you, chronic paresthesia may indicate an underlying condition or trauma.

Paresthesia is an abnormal nerve sensation. It most often (but not exclusively) affects hands, feet, arms, and legs. The feeling has been described as:

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

The strange prickling is often a good sign, indicating that blocked nerves are returning to normal function.

Temporary or transient paresthesia is usually harmless, but if the feeling persists or is accompanied by other symptoms, you should see a doctor.

There are a large number of paresthesia causes, both for temporary paresthesia and for chronic paresthesia. Because of the wide variety of potential causes, diagnosis often has to rely on other symptoms.

Temporary paresthesia

In addition to a manually compressed nerve (such as when you fall asleep on your arm), temporary paresthesia may be caused by any of the following:

• Whiplash
• Hyperventilation
• Panic attacks
• Seizures
• Dehydration
• Circulatory disorders
• Repetitive motion

Chronic paresthesia

Chronic paresthesia may be caused by a large number of each of the following:

• Infections
• Systemic diseases
• Hereditary disorders
• Toxic exposure
• Medications

Common, treatable causes include:

• Diabetes
• Hyperthyroidism
• Nutritional deficiencies

There are also many entrapment neuropathies, disorders in which nerves suffer from chronic compression. A good example is carpal tunnel syndrome. In it, the carpal tunnel, a narrow passageway in your wrist, is damaged so that it continually compresses the median nerve, causing pain and tingling in your hand and wrist.

You should see the doctor if paresthesia does not resolve on its own. Constant or intermittent paresthesia that is accompanied by pain may indicate serious nerve damage. In cases of both carpal tunnel and diabetic neuropathy, paresthesia acts as a warning sign and should prompt you to seek treatment before your condition further deteriorates.

Paresthesia that is accompanied by weakness may indicate underlying problems of the nervous system. If you notice decreased muscle function along with numbness, you should see your physician.

Paresthesia can also occur during a stroke. If the sensation comes on suddenly and is accompanied by weakness, facial drooping, or slurred speech, contact emergency medical services.

In order to diagnose the cause of chronic paresthesia, your doctor will likely begin with a detailed history and physical examination. The presence of other symptoms, the speed of progression, and location may all help your doctor locate the disorder and decide what to do next. 

Further tests may include any of the following:

• Blood tests
• Genetic testing
• Nerve conduction studies
• Electromyography
• Nerve biopsy
• X-ray
• Magnetic resonance imaging (MRI)
• Computed tomography (CT) scan

The tests ordered will depend on your doctor’s suspicions about what is causing your paresthesia.

In order to treat paresthesia, your doctor will come up with a plan that both treats the underlying condition and manages symptoms. Depending on the condition, treatment may be anything from surgery to drug therapy to lifestyle changes.

Your doctor will also help you manage the discomfort associated with paresthesia. Potential treatments include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen
• Anti-seizure medications
• Antidepressants
• Topical sprays or creams that contain lidocaine or capsaicin
• Narcotics

Your doctor may also recommend that you wear certain supports or lose weight.