Paresthesia: Symptoms, Causes & Treatment

Paresthesia is a tingling, pins-and-needles, or numb sensation that can occur in different parts of the body, such as the face, hands, or legs. It is usually temporary and may be caused by anxiety, stress, or sleeping on your arm, for example.

Paresthesia is not always a serious problem. However, it can sometimes occur with other symptoms, such as headache or persistent loss of sensation in the affected area.

In some cases, paresthesia may be linked to serious conditions, such as uncontrolled diabetes or nerve disorders. It is important to see a neurologist or primary care provider, especially when other symptoms are present, to identify the cause and start appropriate treatment.

Main symptoms

The main symptoms of paresthesia are:

• Tingling, numbness, burning, pins and needles, or a prickling sensation in the face, hands, legs, or other parts of the body

• Temporary changes in movement or coordination in the affected area

• Headache

• Weakness or loss of sensation in the affected area

• Pain in the affected area

• A feeling of heaviness in the area

Based on the CDC’s stroke warning signs, sudden numbness or weakness in the face, arm, or leg, especially on one side of the body, may be a sign of stroke and requires urgent medical attention.

For non-urgent cases, see a neurologist or primary care provider if paresthesia has no obvious cause, happens often, does not go away, or occurs with additional symptoms beyond tingling or numbness.

Confirming a diagnosis

The evaluation of paresthesia is usually performed by a neurologist or primary care provider based on the symptoms reported. To identify the underlying cause, blood tests may be ordered, such as a complete blood count (CBC), vitamin B12 levels, and calcium levels, as well as electromyography (EMG) and nerve conduction studies.

Other tests, such as magnetic resonance imaging (MRI), an electroencephalogram (EEG), genetic testing, or even a nerve biopsy, may also be needed depending on the suspected diagnosis.

Possible causes

The main causes of paresthesia are:

• Anxiety or stress

• Nerve compression, which can happen when sleeping on part of the body, for example

• Migraine

• Use of medications, such as topiramate or acetazolamide

• Excessive alcohol consumption

• Uncontrolled diabetes

• Low levels of vitamins and minerals in the blood, such as phosphorus, potassium, or calcium

• Epilepsy

• Infections, such as untreated HIV or syphilis

• Multiple sclerosis

• Stroke

According to the CDC, diabetes-related nerve damage can cause tingling, “pins and needles,” numbness, weakness, and pain, most often affecting the feet but also potentially affecting the hands, legs, and arms.

As paresthesia can have multiple causes, it is important for a neurologist or primary care provider to identify the underlying cause so the most appropriate treatment can be started, if needed.

Treatment options

Treatment for paresthesia depends on the underlying cause and may include:

• Adjusting the dose or discontinuing medications, when they are contributing to symptoms

• Correcting nutritional deficiencies with vitamin or mineral supplementation

• Using anticonvulsants when paresthesia is associated with conditions such as epilepsy or migraine

• Prescribing corticosteroids or immunomodulatory therapies in cases of multiple sclerosis

• Managing blood sugar with oral medications or insulin when symptoms are related to diabetes

• Treating infections, such as HIV or syphilis, with appropriate antibiotics or antivirals

• Using antidepressants or anti-anxiety medications when symptoms are linked to anxiety or depression

• Wearing braces or splints to reduce nerve compression, particularly during sleep

• Considering surgery when paresthesia is caused by nerve compression and does not improve with other treatments

Depending on the cause, physical therapy may also be recommended. Lifestyle changes, such as reducing alcohol intake, following a balanced diet, and achieving a healthy weight, can also help manage symptoms.

Can paresthesia be cured?

Paresthesia can be treated or relieved in some cases, particularly when it is caused by a reversible condition such as a nutritional deficiency or nerve compression. However, when it results from genetic disorders, a cure may be difficult, even with appropriate medical treatment.