That burning, “pins and needles” sensation you experience when your arm or leg falls asleep is called paresthesia. While the vast majority of paresthesia cases go away once you change positions, there are underlying conditions that can cause chronic discomfort.
Paresthesia can occur anywhere in the body, but symptoms are most often experienced in the hands, arms, legs and feet. Paresthesia of the face can also occur, and onset is typically quite sudden.
Underlying paresthesia causes include chronic health conditions like diabetes, certain autoimmune diseases, multiple sclerosis and systemic infections. In some cases, severe anxiety attacks can cause paresthesia in the head, as can migraines.
Additionally, numbness, weakness and burning sensations can occur because of certain medications, chemotherapy treatment, repetitive movements and nutritional deficiencies.
Effective paresthesia treatment depends on finding the root cause of the symptoms. Diagnosis can be a challenge and is often quite involved with a wide range of tests to rule out serious underlying conditions.
What Is Paresthesia?
Paresthesia is a condition marked by distinctive symptoms including numbness, tingling, burning and pins and needles sensations, most often experienced in the extremities. This condition can be classified as either acute or chronic.
According to the National Institute of Neurological Disorders and Stroke, paresthesia can be acute, like when your arm falls asleep, or chronic. Acute paresthesia can develop quite fast and may be a sign of a medical emergency like a stroke. It can also be a sign of a physical trauma or injury. With acute paresthesia, the symptoms abate after successful treatment of the cause. (1)
Chronic paresthesia may be a sign of an underlying medical condition, neurological disease or evidence of traumatic nerve damage. In chronic paresthesia, the symptoms are persistent and are often related to a chronic disease making treatment more difficult. For example, peripheral neuropathy can last for years or be a lifelong battle; it is also known to cause paresthesia.
Signs and Symptoms
Common symptoms of paresthesia include:
- Tingling or burning sensation in the extremities
- A crawling sensation on the skin
- Stabbing pains
- Difficulty walking or poor balance
Causes and Risk Factors
Chronic paresthesia can be caused by a wide range of underlying conditions: (1, 2)
- Stroke, a medical emergency where the blood supply to the brain is interrupted or limited, can cause tingling, numbness and weakness associated with paresthesia.
- Mini-stroke or transient ischemic attack, like a stroke, but lasting only a few moments, can be a warning sign of an impending stroke. Ischemic attacks are known to cause symptoms similar to stroke. (4)
- Multiple Sclerosis, a disease of the central nervous system that goes through periods of relapsing and remitting. One of the symptoms of MS is tingling and numbness in the extremities.
- Encephalitis, an inflammation of the brain often caused by a viral infection. (3)
- Transverse myelitis, a neurological disorder where inflammation affects both sides of the spinal cord, interrupting messages the spinal cord sends throughout the body, which can result in paresthesia symptoms. (4)
- Tumor or vascular lesion pressing on the brain or spinal cord causing a disruption in nerve signals, resulting in symptoms and pain.
- Carpal tunnel syndrome, a condition that causes paresthesia symptoms due to a compressed nerve in the passageway near the wrist often because of repetitive movements.
- Peripheral neuropathy, which is damage to peripheral nerves that affects sensitivity, coordination and muscle control. (5)
- Nerve damage caused by a trauma or whiplash.
- Sciatica, which is a radiating pain along the sciatic nerve running from the lower back to the hips, buttocks and lower legs that can also cause numbness and burning sensations.
- Pinched nerve
- Vitamin B12 deficiency, one of the most common nutrient deficiencies across the globe. (6)
- Copper deficiency
- Vitamin D toxicity
- Vitamin B 6 imbalance — either deficiency or excess
- Systemic infection, including HIV or herpes simplex
- Panic Attack
- Certain types of chemotherapy drugs
- Certain antibiotics
- Certain medications for HIV/AIDS
- Certain anti-seizure medications
- Antidepressant withdrawal
Recognized risk factors include: (7)
- Autoimmune diseases including lupus, rheumatoid arthritis and sarcoidosis (8)
- Neurological diseases like multiple sclerosis
- Type 1 or 2 diabetes
- Alcohol abuse, including alcoholism and binge drinking
- Poor diet that causes nutritional deficiencies
- Repetitive movements such as typing, playing a sport or instrument.
- Restless legs syndrome
Diagnosis and Conventional Treatment
As paresthesia can be caused by a wide range of physical traumas, nutrient deficiencies and underlying health conditions, an accurate diagnosis relies on a complete picture of your health. When symptoms of paresthesia present, it is imperative that urgent health conditions like stroke, transverse myelitis, Guillain-Barre syndrome and others be considered as the cause. (9)
Once urgent conditions are ruled out, a detailed medical history and a variety of tests will be conducted. Likely the physician will order: (10)
- Blood tests for diabetes, nutrient levels (both overdose and deficiencies), thyroid function, infection and levels of toxins or heavy metals
- Examination of any rashes
- Spinal examination including MRIs and X-rays to check for scoliosis or fractures
- Neurological examination to evaluate sensory perception in the extremities
- Evaluation while walking to note any abnormalities in gait, imbalance or coordination
- Lumbar puncture if Guillain-Barre syndrome is suspected
- Nerve testing, and a peripheral nerve biopsy if vasculitis, sarcoidosis or other nerve-related conditions are suspected
- CT scans when a stroke or MS is suspected
Conventional treatment of paresthesia depends on the root cause. Treating underlying nutrient deficiencies, autoimmune diseases, infections and physical nerve or bone problems may help relieve the symptoms.
There are hundreds of clinical studies underway now evaluating the safety and efficacy of a wide range of procedures and medications for paresthesia based on specific diagnoses including: (11)
- Paresthesia induced by chemotherapy
- Carpal Tunnel Syndrome
- Peripheral neuropathy
- Diabetic neuropathic pain
- Restless legs syndrome
- Raynaud’s syndrome
- Chronic back pain
- Traumatic brain injury
5 Natural Tips for Managing Paresthesia
1. Vitamin D
A vitamin D deficiency is linked to restless legs syndrome, certain autoimmune diseases, chronic pain and multiple sclerosis, all of which are known to cause paresthesia symptoms. Spending more time outdoors in the sun (without sunscreen) can help, but if you have a severe deficiency, you may need to add a supplement. Your doctor can order a test to determine your vitamin D levels and help you come up with a plan to boost your levels. (12, 13)
In addition to spending 20 minutes or so of time in the sun each day, adding vitamin D-rich foods like wild-caught halibut, mackerel, swordfish and sardines can help. Mushrooms exposed to UV light including maitake and portobellos, are also good sources.
A relatively new non-invasive treatment for pain, a TENS machine, or transcutaneous electrical nerve stimulation device, provides controlled electrical currents that stimulate nerves. It has been shown to relieve certain types of musculoskeletal pain and postoperative pain, and now it is being studied for chemotherapy-induced paresthesia. (14)
Following up a pilot study, this small clinical trial is evaluating the therapeutic response of TENS on paresthesia and neuropathic pain in those with chemo-induced paresthesia to see if it improves the quality of life. It may be helpful in relieving paresthesia symptoms due to other causes as well as the device is designed to activate your body’s pain-fighting response. (15)
Widely studied for chemo-induced neuropathy with or without paraesthesia, acupuncture may help to relieve the pain and discomfort associated with paresthesia. In one small clinical trial treating chemotherapy-induced paraesthesia, patients were given three acupuncture sessions per week for four weeks, followed by one week off. Treatment rotated like this for a total of 20 sessions. Researchers report that results were promising and urge more clinical trials. (16)
Additionally, acupuncture is an effective treatment for carpal tunnel syndrome. Researchers believe that acupuncture can be effective at relieving carpal tunnel pain and may actually help heal injured peripheral nerves, according a a study published in the Journal of Clinical and Experimental Medicine. (17)
4. Vitamin B6- and B12-rich foods
For mild to moderate deficiencies in these nutrients, adding vitamin B6-rich foods and vitamin B12-rich foods is recommended.
For vitamin B12, consuming one serving of wild-caught fish like mackerel, salmon, herring or tuna a day can provide several times the recommended daily dose. In addition, organic yogurt, turkey, beef and lamb are good sources.
If the vitamin B12 deficiency is severe, your physician may recommend a supplement — for example 1,000 micrograms of vitamin B12 for seven days and then a dose of 1,000 micrograms monthly. (18)
If you have a vitamin B6 deficiency, talk to your doctor before taking a supplement as it interacts with a wide range of medications including chemotherapy, certain high blood pressure drugs, asthma medications, antibiotics and some antidepressants. Instead, add vitamin B6-rich foods to your diet including organic turkey breast, grass-fed beef, pistachio nuts and avocado.
Known for its anti-inflammatory properties, turmeric may be an effective treatment for several of the causes of paresthesia including rheumatoid arthritis, infectious diseases and diabetes. For diabetics, turmeric may help stabilize blood sugar levels staving off diabetic neuropathy and may help relieve pain once the neuropathy has developed. (19, 20)
Choose a high-quality turmeric supplement, preferably fermented and containing black pepper for maximum absorbability. Adding fresh, organic turmeric to your diet is also advisable. Again, to make sure your body can absorb it, be sure to use a recipe that includes both a healthy fat like ghee, as well as black pepper. Try my Paleo-friendly recipe for Soba Noodles with Turmeric Thai Sauce to reap the benefits of this ancient spice.
Eating a nutrient-dense diet to help prevent nutritional deficiencies associated with paresthesia. In addition, as inflammation is a key part of the puzzle with paresthesia, eating a diet low in inflammatory foods, may help symptoms. The Healing Foods Diet focuses on foods that lower glucose, eliminates toxins, alkalizes the body and decreases inflammation.
If you have diabetes, or prediabetes, it is imperative that you manage your blood glucose levels to healthy levels to keep from developing diabetic neuropathy.
Avoid prolonged repetitive movements to limit the chance of nerve damage. This includes activities like typing, playing video games, playing tennis and any other repetitive movement — even painting walls can cause damage.
With any repetitive movement, take time to stretch before the activity and afterward, and take short, periodic breaks to change movement patterns to give your body a break.
If tingling, numbness or burning sensations appear abruptly, seek medical attention immediately. Paresthesia symptoms can be a sign of a serious medical emergency like stroke, transverse myelitis or even Guillain-Barre syndrome. (9)
- Paresthesia refers to physical sensations like pins and needles, numbness and burning that often occurs in the extremities.
- It can be acute, like when your foot falls asleep, or it can be chronic if you have certain underlying health conditions that are known to cause paresthesia symptoms.
- This condition can be caused by a wide range of conditions like a systemic infection, stroke or diabetes, or the symptoms may be caused by a nutritional deficiency, chemotherapy treatment or a repetitive movement injury like carpal tunnel syndrome.
- Diagnosis requires multiple tests, including a physical examination, blood tests, urine tests and imaging tests.
- Conventional treatment focuses on the root cause of the symptoms.
5 Natural Tips for Managing Paresthesia
1. Vitamin D. Spend 10 to 20 minutes in the sunshine each day and add a supplement if you have a severe deficiency to help reduce the pain and discomfort of paresthesia.
2. TENS. Use a TENS machine to stimulate nerves and treat pain associated with chemotherapy-induced paresthesia.
3. Acupuncture. Have acupuncture to to treat chemotherapy-induced paresthesia and carpal tunnel syndrome.
4. Vitamin B6 & B12 rich foods. Include these in your diet to treat mild-to-moderate deficiencies.
5. Turmeric. To help stabilize blood sugar levels to keep diabetic neuropathy from developing, and to treat inflammation in the body associated with rheumatoid arthritis and certain infectious diseases and diabetes.
Read Next: Top 10 Pain-Triggering Foods