Pins and Needles?

Why do I have tingling in my hands?

Hand numbness can be caused by damage, irritation, or compression of one of the nerves or a branch of one of the nerves in your arm and wrist.

Diseases affecting the peripheral nerves, such as diabetes, also can cause numbness, although with diabetes, similar symptoms usually occur first in your feet.

Uncommonly, numbness may be caused by problems in your brain or spinal cord, although in such cases arm or hand weakness or loss of function also occurs.

‘Pins and needles’ (paresthesia) is a sensation of uncomfortable tingling, prickling, itching or skin crawling, usually felt in the hands or feet. The affected area is sometimes said to have ‘fallen asleep’.

A common cause of pins and needles is leaning or lying awkwardly on an arm or leg, which either presses against the nerves or reduces the blood supply to the local area. Changing position usually quickly restores normal feeling as the nerves start sending messages to the brain and spinal cord again.

Symptoms of pins and needles

Common features of pins and needles include:

  • prickling and tingling sensation
  • numbness
  • return of normal feeling a few minutes after changing position.

Hands, arms, legs and feet are the parts of the body most commonly affected.

Pressure-related pins and needles
The nerves of the body send information back to the brain and spinal cord. When a sensory nerve is pressed by being in a cramped or awkward position the messages are interrupted, which can cause pins and needles.

Once pressure is taken off the nerve, functioning resumes. An uncomfortable prickling sensation is caused by the restarting of pain messages from nerves to the brain. This usually resolves within minutes. An example of this is when you hit your elbow and feel a tingling sensation in your little finger.

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.

When to seek medical advice for pins and needles

The occasional bout of pins and needles is a harmless event. However, chronic pins and needles can be a warning of some other underlying disorder.

Always see your doctor if you experience frequent or persistent bouts of pins and needles.

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 osteopathy, medication or (in some cases) surgery to ease the pressure and allow full nerve functioning to resume.

Understanding Nerve Pain and How to Fix It

What are nerves?

Nerves transmit information between the brain and the rest of the body. Some information goes from the body up to the brain, like temperature on your skin, and some information goes the other way, like the brain causing muscles to contract in order to move.

The nerves of the body are divided into two categories. We have the central nervous system (CNS) which involves the brain, brainstem and spinal cord. And we have the peripheral nervous system (PNS) which includes all the nerves from the limbs, organs and rest of the body that link up with the CNS at the spinal cord.

Fun Fact: the eyes are made up of nervous tissue and can be considered a direct extension of your brain, rather than a separate organ like the stomach or heart.

What is nerve pain?

Pain that is caused by irritation or damage to a nerve often feels different to regular musculoskeletal pain. It can feel like a stabbing, shooting, or electric feeling, often accompanied by tingling, burning, or prickling. Nerve irritation can even cause a temporary loss of feeling, numbness, or weakness.

What causes nerve pain?

There are multiple causes of nerve pain. Nerves can become irritated when they are physically compressed, such as from a tight muscle, an injured disc, or even a tight waist-belt. Irritation can also be caused by chemical irritation and inflammation, which can be influenced by our overall health, such as diet and physical activity levels. Furthermore, nerves can become damaged secondary to other health conditions, such as diabetes, shingles, heart disease, or autoimmune diseases.

How is nerve pain treated?

In most cases nerve pain has a very positive prognosis, meaning it can begin to feel better without too much intervention. Identifying the cause of the nerve pain is important, as each cause will have a different treatment approach.

Reducing irritation to the nerve is an integral first step, this can be achieved by altering positions that put the nerve on tension. Examples of this include adjusting the set up of your desk or workstation, altering the position of your car seat, retraining lifting techniques, getting properly fitted for your bicycle, and more!

Manual therapy can also be utilised, helping to provide direct pain relief, relax muscles around the irritated nerve, and get the joints and pathways of the nerve moving well. Individually tailored exercises should also be used to increase strength and control, and gradually increase your exposure to movements that previously irritated the nerve.

If your pain is quite bad, your doctor may discuss medications that target nerve pain more specifically than simple analgesics, like paracetamol.

If several weeks of conservative treatment, including lifestyle changes, manual therapy, exercises, and medication is having no effect, then it may be necessary to discuss other options with your doctor. This may include testing for other causes of nerve pain, utilising injections or nerve blocks, or possibly considering surgical options.

However, conservative treatment is routinely recommended as the first-line approach, as research consistently shows that the long term effects of non-operative treatment are similar or better than surgery.