What Is a Paresthesia and What Causes It?
Key takeaways:
A paresthesia is an abnormal sensation, such as numbness or tingling, due to nerve injury or dysfunction.
A common example is the feeling of your hands or feet “falling asleep” when they’re in one position for too long.
Many injuries and conditions can cause paresthesias, so it’s important to work with your medical provider to find out the cause.
Most of us have experienced the sensation of a hand or foot “falling asleep” before: feelings like numbness, pins and needles, and sometimes shooting pain. These sensations are called paresthesias. They are most common in the legs, feet, hands, and arms.
Paresthesias are usually symptoms of some kind of nerve dysfunction, known medically as neuropathy. But they can have many causes, some of which are more serious than others. Paresthesias usually go away with time, as in the case of your foot falling asleep. But, if they are due to an ongoing medical problem, they could persist.
Let’s talk about why paresthesias arise, what they could mean, and what to do about them.
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What are the symptoms of a paresthesia?
A paresthesia is actually a symptom itself. It can feel like the affected part of your body has “fallen asleep.” Common sensations include:
Numbness
Tingling
Pins and needles
Shooting pain
Hot or cold sensation
In many cases, these sensations go away on their own. But if they persist, it’s a good idea to talk to your medical provider. Read more on this below.
What are common causes of paresthesias?
Paresthesias have a wide range of causes. They can be caused by neuropathy linked to nutritional deficiencies (like with B vitamins), diabetes, infections, and exposure to toxins like alcohol and heavy metals. But paresthesias also result from nerve compression or injury and temporary loss of blood supply.
Nerve injury or compression
Hitting your elbow on a hard surface and sitting on the toilet for too long (until your legs go numb) are common examples of nerve injury and compression. If the injury isn’t serious or the pressure on the blood vessels is short-lived, the nerves usually recover quickly. So the abnormal sensation that results typically goes away in seconds to minutes.
With some injuries, however, paresthesias can last longer. This usually indicates that a nerve is trapped or severely irritated. Two well-known issues related to trapped nerves are carpal tunnel syndrome and cubital tunnel syndrome. These often result from a person performing repetitive wrist or elbow motions.
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Nerve damage near the spine can also cause paresthesias. Radiculopathy occurs due to pressure on one or more of the nerves as they exit the spine. Irritation from that pressure causes nerve-related pain, such as paresthesias.
Similarly, myelopathy occurs due to pressure on the spinal cord itself, causing paresthesias. This pressure can often result from trauma, a herniated disc, or narrowing around the spinal cord or the exiting nerves.
Nerve blood supply
Nerves need continuous blood supply in order to stay healthy and function normally. When the blood supply to a nerve is decreased, it can result in nerve dysfunction or damage, leading to paresthesias. This can happen with smoking, which makes blood vessels smaller. It can also happen when blood vessels are blocked due to cholesterol plaques or blood clots. With diabetes, ongoing high blood sugar can affect the blood supply to the nerves, causing paresthesias.
What are less common causes of paresthesias?
Several serious diseases cause paresthesias. In these cases, paresthesias often last longer (several months) and also cause weakness.
These less common but more serious causes of paresthesias include, but are not limited to:
Neurologic diseases like multiple sclerosis
Spinal cord injuries, infections, and tumors
Autoimmune diseases like rheumatoid arthritis and lupus
Strokes and “mini-strokes”
Certain cancers
Chemotherapy medications
Inherited disorders like hereditary neuropathy with liability to pressure palsies
How do I know if my paresthesia is serious or not?
In addition to looking at the list above, there are a few scenarios that could indicate higher severity. For example, paresthesias that last more than a few weeks or months and those that are accompanied by pain or other sensations that become more intense over time should be evaluated.
The presence of other symptoms can also indicate higher severity. These include:
Fatigue
Weakness
Clumsiness
Weight loss
Chest pain
Vision changes
Difficulty talking or swallowing
Dizziness
Difficulty breathing
If you have paresthesias with these characteristics, it’s best to get medical attention. A careful history, physical examination, and other diagnostic tests will likely shed some light on the cause of the paresthesias. It’s best to get to the bottom of things as early as possible to prevent any nerve damage from worsening.
How are paresthesias treated?
Since paresthesias are caused by other conditions, the best initial plan is treatment of the underlying problem.
Sometimes, this could be as simple as changing the dose of a medication or taking a supplement to address a vitamin deficiency. Or it might entail taking a new medication, like in cases in which people have diabetes or an infection that’s causing their paresthesias. It could also mean having more invasive treatments like injections or surgery, like in cases of carpal tunnel syndrome and conditions of the spine.
If you have paresthesias that don’t go away despite treatment of an underlying problem, several types of medications could be helpful. Examples include:
Over-the-counter pain medications, such as acetaminophen and ibuprofen
Topical treatments, such as capsaicin and anti-inflammatory creams
Oral prescription medications, such as gabapentin and pregabalin
Of course, there is no one-size-fits-all treatment for paresthesias, as treatment depends on the specific cause. It’s best to work with your healthcare provider to decide the best course of action for you.
The bottom line
Paresthesias are usually a result of some form of nerve injury, often what’s classified as peripheral neuropathy. In many instances, the nerves will recover on their own. If the issue persists, talk to your healthcare provider. They can help provide a diagnosis and find treatment options to improve your quality of life.
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References
American College of Rheumatology. (2021). Carpal tunnel syndrome.
American Society for Surgery of the Hand. (2015). Cubital tunnel syndrome.
Johns Hopkins Medicine. (n.d.). Myelopathy.
Johns Hopkins Medicine. (n.d.). Radiculopathy.
National Health Service. (2019). Peripheral neuropathy - Diagnosis.
Rubin, M. (2020). Hereditary neuropathy with liability to pressure palsies (HNPP). Merck Manual Consumer Version.
