Pins and needles
“Pins and Needles”
What is it?
Medically “pins and needles” is known as paraesthesia and we’ve all experienced the prickling, tingling, numbing or burning feelings that occur after accidentally sleeping on an arm or sitting on a hard toilet seat for too long. The nerve is temporarily squashed but normality returns within a minute or two of moving. Some pins and needles are however longer lasting and this phenomenon often merits further investigation.
What causes long term pins and needles?
Many cases of long term pins and needles that I see are also caused by mechanical nerve compression but the cause of the compression may not disappear so easily. For example pins and needles in the hand may be coming from the wrist (carpal tunnel syndrome), forearm (pronator teres syndrome), elbow (ulnar nerve injury), or neck (spondylosis/osteoarthritis). The particular fingers affected often give a good clue as to the precise whereabouts of the nerve compression. However it is important to be aware of the many other potential causes of paraesthesia.
Sometimes the nerve itself may become diseased (neuropathy), often as a consequence of other medical problems. For example, diabetes can commonly lead to pins and needles especially if it isn’t controlled properly, as can Vitamin B12 deficiency, malnutrition, chronic alcohol abuse, chemotherapy, hyperventilation, toxin exposure and neurological disease. Occasionally arterial disease may show up as pins and needles too.
What can be done?
As ever accurate diagnosis is the key. The vast majority of cases that I see in practice have a simple mechanical explanation and can be treated using the time honoured hands on techniques to “free up” the nerve. However in severe cases or when a medical problem is suspected I liaise with the GP to achieve the best result for the patient.