Paresthesia is numbness or a burning feeling that occurs most often in the extremities, such as the hands, arms, legs, or feet, but that can happen elsewhere in the body as well.
It is the same “pins and needles” feeling that happens when someone sits on their leg or foot for too long. Usually a temporary sensation, it is caused when pressure is placed on the nerve that supplies a limb. Once that pressure is relieved, the discomfort goes away.
Some people have chronic or long-term paresthesia, which can be a sign of a more serious nerve injury or condition.
There are many different causes of chronic paresthesia, including:
- multiple sclerosis
- tumor in the spinal cord or brain
- high levels of vitamin D or other vitamins
- high blood pressure
- nerve injury
- compressed, or pinched, nerve
A pinched nerve occurs when there is too much pressure put on it by the surrounding tissue. This pressure causes paresthesia in the area supplied by that nerve, and its function is interrupted. A pinched nerve can happen anywhere in the body, such as the face, the neck, the wrist, or the back.
A herniated disk in the lower spine can cause pain in the back, leg or foot on the affected side.
Carpal tunnel syndrome is a pinched nerve in the wrist that causes numbness and tingling in the fingers.
The symptoms of paresthesia or a pinched nerve include:
- tingling or a “pins and needles” sensation
- aching or burning pain
- numbness or poor feeling in the affected area
- feeling that the affected area has “fallen asleep”
- prickling or itching feeling
- hot or cold skin
The symptoms can be constant or intermittent. Usually, these sensations occur in the affected area but may spread or radiate outward.
Some factors increase the risk of having a pinched nerve:
- Gender: Women are more likely to get carpal tunnel syndrome, possibly due to a narrower nerve canal.
- Obesity: Extra weight can put pressure on nerves.
- Pregnancy: Weight and water gain associated with pregnancy can cause swelling and pressure on nerves.
- Thyroid disease: This puts a person at risk for carpal tunnel syndrome.
- Diabetes: Having diabetes can cause nerve and tissue damage.
- Rheumatoid arthritis: This causes inflammation, which can also compress nerves in the joints.
- Prolonged bed rest: Lying down for extended periods can cause nerve compression and increase the risk for paresthesia.
- Overuse: People who have jobs or hobbies that require repetitive motion of the hands, elbows or feet are at a higher risk for a pinched nerve, paresthesia or nerve damage.
Anyone can get a pinched nerve, and most people will have experienced paresthesia at some point or another.
To diagnose paresthesis, a doctor will first take a medical history and ask questions about a person’s symptoms.
Next, the doctor will likely perform a physical examination and, depending on the findings, may recommend tests, including.
- Nerve conduction study: This measures how fast nerve impulses travel in the muscles.
- Electromyography (EMG): To look at the electrical activity of how nerves and muscles interact.
- Magnetic resonance imaging (MRI): This can be used to look at the different areas of the body in high detail.
- Ultrasound: Used to produce images of the body, this can be applied to smaller areas to look for nerve compression or damage, such as occurs in carpal tunnel syndrome.
The type of test that the doctor prescribes will depend on the results of these tests, plus a person’s symptoms and medical history.
The treatment options for paresthesia depend on the cause. If there is an underlying medical condition causing the symptoms, then treating the condition should also treat the paresthesia.
Rest and bracing
Rest is commonly recommended for a pinched nerve.
It is important to stop the activities that are causing the nerve compression to allow the tissues to heal. This may mean resting, or sometimes a brace or splint is needed to stop movement of the area.
For example, a wrist brace can be used to immobilize the wrists in a person with carpal tunnel syndrome.
However, using a brace for extended periods of time can cause other problems. Hence, the recommendations of someone’s doctor should always be followed.
Physical therapy can be used to build strength in the muscles surrounding the affected nerve. Stronger muscles can help relieve tissue compression and prevent it reoccurring. Fit muscles can also improve flexibility, the range of motion and mobility.
Some medications, such as ibuprofen (Advil, Motrin) and naproxen sodium (Aleve) and even steroid injections into the affected area can be given to relieve pain and decrease swelling and inflammation.
For long-term paresthesias due to fibromyalgia, medications, including pregabalin (Lyrica) or duloxetine (Cymbalta), may be useful.
If these treatments do not relieve the symptoms, surgery may be needed to reduce the pressure on a pinched nerve.
Surgery can mean releasing the carpal ligament, removing a bone spur, or even part of a herniated disk in the back.
The type of surgery will depend on the specific symptoms a person is experiencing, as well as their cause.
While not every pinched nerve is preventable, there are things a person can do to help minimize the risk of one happening.
Maintaining good posture and body positioning is vital to avoid unnecessary pressure on the nerves.
Avoiding injuries that can occur from heavy and incorrect lifting is also critical. By being mindful of the body’s position, and by changing positions frequently, a person can avoid nerve compression, which may lead to paresthesis.
Also, limiting repetitive movements, or at least taking frequent breaks while doing those activities, can prevent paresthesia that is caused by overuse.
As always, maintaining a healthy weight and participating in regular exercise, including strength and flexibility exercises, are good strategies for building strong and healthy muscles.
The outlook for someone with paresthesia varies and depends on what is causing the symptoms. A pinched nerve that only lasts for a short time usually causes no permanent damage.
If the pinched nerve continues, however, it can lead to permanent damage, chronic pain, and loss of function and sensation.
In some cases where medical treatment and therapy have not helped, surgery may be necessary to correct the problem.