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Paresthesia: Causes, Symptoms, Diagnosing and Treatment

  • Date: 2010/04/15 (Rev: 2018/03/16) Thomas C. Weiss - disabled-world.com
  • Synopsis : Paresthesia is a prickling or burning sensation that a person experiences in their feet, legs, arms or hands.

Main Document

Chronic paresthesia is often a symptom of an underlying neurological disease or traumatic nerve damage. Paresthesia can be caused by disorders affecting the central nervous system, such as stroke and transient ischemic attacks (mini-strokes), multiple sclerosis, transverse myelitis, and encephalitis. A tumor or vascular lesion pressed up against the brain or spinal cord can also cause paresthesia. Nerve entrapment syndromes, such as carpal tunnel syndrome, can damage peripheral nerves and cause paresthesia accompanied by pain.

Paresthesia is defined as an abnormal sensation of the body, such as numbness, tingling, or burning. These sensations may be felt in the fingers, hands, toes, or feet. Depending on the cause, the sensation of paresthesia can be short-term and disappear quickly, such as when it occurs due to hyperventilation, an anxiety attack or from lying on the arm while asleep. Most people have experienced temporary paresthesia, a feeling of pins and needles, at some time in their lives when they have sat with legs crossed for too long, or fallen asleep with an arm crooked under their head. It happens when sustained pressure is placed on a nerve. The feeling quickly goes away once the pressure is relieved. Some individuals may experience chronic paresthesia. This is usually a symptom of severe underlying conditions.

Causes of Paresthesia

When a person experiences paresthesia, symptoms from a wide-range of possibilities may occur. There are a number of potential causes as well; multiple sclerosis for instance. The list below includes many of the potential causes of paresthesia.

  • Migraines
  • Alcoholism
  • Neuropathy
  • Malnutrition
  • Menopause
  • Dehydration
  • Fibromyalgia
  • Herpes zoster
  • Hypoglycemia
  • Fabry disease
  • Nerve irritation
  • Atherosclerosis
  • Hyperventilation
  • Multiple sclerosis
  • Immune deficiency
  • Metabolic disorders
  • Lidocaine poisoning
  • Anticonvulsant drugs
  • Lupus erythematosus
  • Neurological disorders
  • Motor neuron diseases
  • Lyme disease infection
  • Beta-alanine ingestion
  • Autoimmune disorders
  • Heavy metal poisoning
  • Guillain-Barre Syndrome

Symptoms of Paresthesia

Interestingly, paresthesia itself is something that can be considered a symptom of certain conditions. The lack of one of the conditions mentioned in this article does not necessarily mean that a person is not experiencing some level of paresthesia. In addition, the paresthesia a person experiences may be either chronic, or transient. When paresthesia is caused by a particular condition, additional symptoms might become a part of the person's experience, related to underlying causes. The symptoms of paresthesia may include:

  • Itching
  • Tingling
  • Footdrop
  • Dysarthria
  • Numbness
  • Muscular atrophy
  • Ocular Dysmetria
  • Restless leg syndrome
  • Crawling sensation on the skin
  • "Falling asleep" of limbs such as a hand, foot, arm, leg, etc.

Diagnosing Paresthesia

A diagnostic evaluation of paresthesia is based on determination of the underlying condition that is causing the person to experience paresthesia sensations. A person's medical history, in combination with a physical examination and laboratory testing, are essential for a diagnosis. A doctor might order other tests depending upon the suspected cause of the paresthesia the person is experiencing.

Paresthesia can be classified as either transient or chronic. Transient paresthesia might be a symptoms of hyperventilation or a panic attack. Chronic paresthesia can be the result of nerve irritation, poor circulation, neuropathy, or a number of other conditions or causes. There is no form of long-term physical effect from paresthesia, although its underlying conditions can have a number of effects.

Treatment of Paresthesia

Treatment of paresthesia depends on an accurate diagnosis of the underlying cause. For people with limbs that have fallen asleep, restoration of their circulation through exercising, stretching, or massaging the affected limb can rapidly dissipate the tingling and sensations of numbness. If the paresthesia is due to a chronic disease, such as diabetes, or occurs as a complication of treatments like chemotherapy, the majority of treatments are aimed at relief of the person's symptoms. Anti-inflammatory medications such as ibuprofen or aspirin are recommended if the person's symptoms are mild.

People with more difficult paresthesia might be administered antidepressant medications such as amitriptyline. Antidepressant medications prescribed for paresthesia are given at a much lower dosage than they are for the relief of depression. The medications are believed to help because the alter the person's perception of pain. If the paresthesia a person is experiencing is even more severe, opium derivatives such as codeine might be prescribed. As of the year 1998, trials are being performed in order to determine whether treatment with human nerve growth factor will be effective in regenerating damaged nerves.

There are also a number of alternative treatments available to assist in relieving the symptoms of paresthesia. Nutritional therapy can include B complex vitamin supplementation, particularly vitamin B12. Vitamin supplementation is something that should be pursued with caution; however, because an overdose of Vitamin B6 for example is one of the causes of Paresthesias. People who experience paresthesia should avoid the consumption of alcohol.

Acupuncture and massage are also believed to provide a level of relief from the symptoms of paresthesia. Self-massage with aromatic oils is sometimes helpful as well. The application of topical ointments that contain, capsaicin, the substance that makes hot peppers hot, might provide relief from paresthesia. It can also be helpful to wear clothes and shoes that are loose-fitting.

Quick Facts:

  • Benzodiazepine withdrawal can cause paresthesia as the drug removal leaves the GABA receptors stripped bare and possibly malformed.
  • Joint conditions such as rheumatoid arthritis, psoriatic arthritis, and carpal tunnel syndrome are common sources of paresthesia.
  • Chronic paresthesia indicates a problem with the functioning of neurons or poor circulation.
  • Stroke survivors and those with Traumatic Brain Injury (TBI) may experience paresthesia from damage to the central nervous system.
  • Paresthesia can also be a symptom of vitamin deficiency and malnutrition, as well as metabolic disorders like diabetes, hypothyroidism, and hypoparathyroidism. It can also be a symptom of mercury poisoning.
  • The herpes zoster disease (shingles) can attack nerves causing numbness instead of pain commonly associated with shingles.
  • Medications offered can include the immuno-suppressant prednisone, intravenous gamma globulin (IVIG), anticonvulsants such as gabapentin or Gabitril and antiviral medication, among others, according to the underlying cause.
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