Pins & Needles That Won’t Go Away
By Vijaya Polavaram, M.D.
Numbness is defined as defective touch perception. The common patient description in the doctor’s office is “Feeling like the limb going to sleep or a feeling of limb being heavy.” Numbness is also described as a “tingling sensation” or “pins and needles that won’t go away.” In medical terminology, parasthesia is abnormal numbness and tingling sensations that can occur anywhere in the human body.
Depending on where you have numbness/tingling present, the sensations could be a reflection of various medical diseases. Because the feeling of numbness is a disorder of nervous system, tingling is an abnormal finding. You should seek medical attention as soon as possible if you experience numbness and tingling. The causes of numbness may be divided into two main categories: central nervous system disorders (mainly brain and spinal cord issues) and peripheral nervous system disorders.
• Numbness of one side of the body and face would suggest stroke or brain hemorrhage, so the patient needs to go to the Emergency Room immediately. You should note when the symptoms started since some clot-dissolving
medications can only be given within an hour of the onset of a stroke.
• Episodic or patchy numbness of any part of the body with or without associated blurred vision may indicate possible multiple sclerosis and should be seen by a physician right away.
• Sometimes migraine headaches can cause numbness of the face and body.
• Some brain tumors involving the sensory tracts may be found due to a numbness of the area supplied by that tract.
• Disc herniation of the spinal column can cause pressure on the nerves which causes pinched nerve or radiculopathy sciatica which shows symptoms such as numbness of the limb on the side below the herniated disc level. Spinal cord tumors may cause symptoms of parasthesia and are often associated with weakness of the extremities and dependent on the level of the tumor.
Numbness arising from the diseases of the nerves in the body other than the brain and spinal cord are know as disorders of peripheral nerves.
Nerve entrapment syndromes arise because of increased pressure applied to a nerve as it traverses a closed space.
Entrapment may result from direct external nerve compression or contusion related to work, hobby, trauma, or sport activities. Some examples are conditions such as harp player's thumb, bowler's thumb, or constriction by a watch or bell.
There are several risk factors for the development of lower extremity
entrapment neuropathies:
• Peroneal palsy (foot drop) may result from occupations requiring crouching, squatting, or kneeling (e.g., agriculturalists, miners, shoe salesmen).
• Increased pressure at the popliteal fossa (the shallow depression located at the back of the knee-joint) may occur in those who tilt back in chairs.
• The tarsal tunnel syndrome may result from the use of shoes with an improper arch support.
• Kneeling with the toes flexed inside tight shoes may cause interdigital nerve injury (electricians or carpet layers might experience this injury).
• Nerves that previously have been affected by other issues such as diabetes or alcoholism seem to be more susceptible to entrapment syndromes.
• Carpal tunnel syndrome shows symptoms such tingly and numbness of the fingers due to the inflammation of the bend at the wrist underneath which nerves pass and is commonly seen in people who type and use computers.
• Some toxic neuropathies maybe caused by substances such as alcohol, heavy metals like lead arsenic and mercury, some of the gold components used in treatment of rheumatoid arthritis, some of the cancer chemotherapy drugs, drugs used to treat AIDS, some tuberculosis medicines, or organophosphate pesticides.
• Metabolic causes—Diabetes is one important medical condition where neuropathy itself could be a presenting symptom for a serious medical problem. In diabetics, it is long nerves in the body where nerve involvement first appears (for example, the feet). It is strongly recommended that all diabetic patients visit a podiatrist at least once a year.
• Ureamic neuropathy, the second most common cause of peripheral neuropathy, is seen in people with kidney failure.
Some other medical conditions like adrenal gland diseases, thyroid diseases and liver diseases may also cause neuropathies.
Other causes of Neuropathy:
• Nutritional causes: One of the most common neuropathies related to vitamin deficiency is Vitamin B12 deficiency, commonly seen in vegetarians and people with gastric bypass surgeries. Malabsorption syndromes may also cause peripheral neuropathies due to lack of Vitamins B1, B6 and E.
• Common infections which may also cause neuropathy are HIV, hepatitis, syphilis, Lyme disease, Guillian-Barre, etc.
• Heart attack: Left arm numbness or heaviness sometimes could be a symptom of an ongoing heart attack and requires immediate medical attention.
Most of the neuropathies are treatable provided they are properly diagnosed and addressed accordingly in a timely manner. At the same time, it could well be possible that the condition might become irreversible if there is any delay in seeking medical attention.
Final message is... Having numbness is not normal, so get it checked by medical personnel ASAP.
Dr. Polavaram specializes in internal medicine and is the owner of Capital Primary Care with offices in Cary and Raleigh.
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