‘Pins and needles’ are a sensation of uncomfortable tingling or prickling, usually felt in the arms, legs, hands or feet. A common cause is pressure on a specific part of the arm or leg, which causes compression of nerves. This usually resolves quickly when the position is changed and the pressure is removed. It’s annoying, but you shake things out a bit and move on, no harm done. But if you have frequent or long-lasting tingling sensations, it’s time to head to the doctor.

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‘When someone complains of numbness or tingling in the hands and feet, we look at when it started and how it has progressed because that gives us some insight into the causes,’ explains Stanley Iyadurai, M.D., an assistant professor of neuromuscular medicine at Ohio State University. ‘If we can identify the root cause of the problem, we can treat it or control the symptoms with medicines.’

To get to the bottom of this issue which doctors call neuropathy, you may need blood tests, imaging exams like an MRI or CT scan, or a test called an electromyogram (EMG), which measures the electrical activity in your muscles.

Can pins and needles be dangerous? In these instances, “pins and needles” can be a danger signal. Paresthesia that happens with other symptoms may also indicate an underlying condition. Most often, though, “pins and needles” is just an odd, but harmless, sensation that we feel from time to time.

Long-lasting pins and needles may also be caused by toxic substances – such as lead or radiation, poor diet, nerve damage – after an injury or illness and drinking too much alcohol.

Pinched nerves and pins and needles

Nerves can be compressed or ‘pinched’ by bones and other tissue. Some examples include:

  • Carpal tunnel syndrome– the main nerve that services the hand runs through a ring of wrist bones. Inflamed and swollen tendon membranes reduce the amount of room inside the wrist and irritate or compress the nerve. Symptoms include pins and needles, pain and weakness in the hand
  • Cervical nerve root irritation– nerves in the neck exit the spinal cord via small holes between the vertebrae. These small holes can be narrowed by inflammation, injury or outgrowths of bone tissue (bone spurs). The nerves are irritated or compressed, causing pins and needles and, sometimes, referred pain into the arms
  • Sciatica– the legs and feet are serviced by the sciatic nerve, which starts between the vertebrae of the lower back. This nerve can be irritated or compressed due to problems in the lower back or pelvic or buttock area causing pins and needles, and sometimes pain, down the legs.

A pinched nerve in your neck or back

Got pain and tingling radiating from your neck to your arms or from your back to your feet? You might have a pinched nerve caused by an injury, poor posture, or an underlying condition like arthritis. Physical therapy or a drug like gabapentin should help, says Iyadurai.

The most common causes of tingling in the hands and feet:-

Vitamin deficiency              

If the tingling is happening in both of your hands (not just one), a lack of vitamin B12 could be to blame. You’d also likely feel tired and lethargic, and you might have anemia. If a blood test confirms this problem, B12 supplements or injections should resolve it.

Carpal tunnel syndrome

Too much typing? Been experimenting with power tools? Repetitive motion or vibrations can end up compressing a nerve in your wrist and, in turn, cause tingling in your hands, says Iyadurai. An EMG and ultrasound are typically used to diagnose carpal tunnel syndrome. If you have it, you may need to modify the way you perform daily activities. Other fixes for carpal tunnel include physical therapy, anti-inflammatory drugs, and maybe even surgery.

Cervical or spinal stenosis 

A narrowing of the spaces in the spinal canal in the neck or spine can put pressure on the spinal cord and/or nerve roots, causing tingling sensations, explains Esther Young, D.O., a neurologist at Beaumont Health in Rochester Hills, MI. ‘Stenosis can be diagnosed with an MRI or CT scan and treated with physical therapy, epidural injections, or surgery, depending on the extent of it.’

Diabetes

Whether you have full-blown diabetes or insulin resistance (a common precursor), high blood sugar acts as a toxin to nerves, and can cause tingling in the hands and feet (peripheral neuropathy), explains Iyadurai. If you also have excessive thirst or hunger or you’re urinating frequently, ask your doctor about getting a fasting blood sugar test or an A1C test, which checks glucose levels over the previous 3 months. Lifestyle changes and medication can help get your condition under control.

Hypothyroidism

An underactive thyroid can cause tingling, as well as fatigue, sensitivity to cold, unexplained weight gain, dry skin, and hair loss, Young notes. It can be easily diagnosed with a blood test; if you have it, you’ll need to take synthetic thyroid hormone.

Multiple sclerosis

If you have weakness with the numbness or tingling sensations, plus symptoms like double vision, clumsiness, or bladder- or bowel-control problems, multiple sclerosis (MS) could be the culprit, notes Young. An MRI can reveal the telltale plaques or scarring on the brain or spinal cord that occur with MS. Various medications are available to treat symptoms and slow the progression of the disease.

Treatment for pins and needles

Treatment depends on the cause. For example, carpal tunnel syndrome may be treated with rest, splinting and medications such as anti-inflammatory and diuretic medications. A compressed or irritated nerve may require treatment such as physiotherapy, medication or (in some cases) surgery to ease the pressure and allow full nerve functioning to resume.

Underlying conditions such as diabetes need to be properly controlled to ease associated symptoms, including pins and needles. The symptoms of nerve inflammation and damage caused by chronic over consumption of alcohol generally improve once the person stops drinking.