Pins and needles (also known as paraesthesiae) is a cold, burning, prickling or tingling sensation that is usually felt in the arms, legs, hands or feet. It can also happen in other parts of the body, such as the mouth and neck.
The sensation is normally painless and can cause numbness or itching.
Temporary pins and needles
Most people have experienced temporary pins and needles.
Pins and needles usually happen when weight applied to a part of the body cuts off the blood supply to the nerves in that area. For example, kneeling often causes pins and needles by limiting the blood supply to the nerves in your lower legs.
Symptoms disappear soon after pressure is taken off the affected area.
Chronic pins and needles
Chronic pins and needles that occur frequently over a long period of time are often an indication of a more serious condition, such as multiple sclerosis, peripheral neuropathy or diabetes (see Pins and needles - causes for more information). If you have chronic pins and needles, see your GP.
Treatment for chronic pins and needles will depend on the underlying cause. You may need to make simple lifestyle changes, or you may need more extensive treatment, such as medication or surgery.
Temporary pins and needles occur when pressure is applied to the affected area of the body.
This limits the blood supply to the nerves in that area, which prevents the nerves from sending important signals to the brain.
Chronic pins and needles
Chronic pins and needles are usually a sign of an underlying condition or disease. These include the following:
- A central nervous system disorder, including stroke, brain tumour, brain abscess, multiple sclerosis, encephalitis, transient ischaemic attack (mini stroke) or transverse myelitis (a disease of the spinal cord).
- A connective tissue disease, such as rheumatoid arthritis or Sjogren's syndrome.
- A nerve-entrapment syndrome, such as carpal tunnel syndrome or sciatica.
- A metabolic disease, such as diabetes or hypothyroidism.
- A cardiovascular disease, such as atherosclerosis.
- A disease of the blood vessels, such as Raynaud's phenomenon.
- Neuritis (inflammation of the nerve).
- Infections such as HIV or Lyme disease.
Chronic pins and needles can also be caused by:
- toxic substances, such as exposure to lead or radiation
- certain medications, such as chemotherapy, HIV medication or anticonvulsant medications
- malnutrition (when your body lacks specific nutrients due to a poor diet)
- vitamin B12 deficiency
- direct damage to the nerves by infection or injury
- alcohol misuse
- peripheral neuropathy from another cause
Chronic pins and needles are often the symptom of a more serious condition.
To identify and diagnose the condition responsible for your pins and needles, your GP will look at your medical history and carry out a physical examination.
They may also want to do various tests, depending on the suspected cause of your pins and needles. These may include:
- blood tests
- a nerve or muscle biopsy, where a sample of nerve or muscle is taken to be analysed
- an electromyogram, which measures muscle responses to an electrical stimulus. A needle electrode is inserted through the skin and into the muscle to give an electrical recording of muscle activity when its nerves are stimulated
- a CT scan, which uses X-rays and a computer to create detailed images of the inside of your body
- chemical analysis of your urine
- nerve conduction tests, where small metal discs called electrodes are placed on your skin. The electrodes release small electric shocks that stimulate your nerves. The speed and strength of the nerve signal is measured.
- MRI scan, to look at your brain or spine
If you have temporary pins and needles, you can ease the symptoms by simply taking the pressure off the affected area. If the pins and needles are very uncomfortable you may require medication to help control the symptoms.
If you have chronic pins and needles, the treatment will depend on what has caused it. For example, if it is caused by an underlying condition, such as diabetes, treatment will focus on controlling the condition to ease the symptoms. This may be done through medication or surgery.
Pins and needles may be caused by a vitamin B12 deficiency.The most common cause of vitamin B12 deficiency is pernicious anaemia due to a deficiency of intrinsic factor in the stomach.Ths is an autoimmune disorder.The treatment is by vitamin D injections daily for the first few injections and then monthly for life. In these cases.