Pins and needles

Pins and needles, also called paresthesia, is a tingling, prickling, or “crawling” sensation often felt in the hands, arms, legs, or feet. It is usually temporary and caused by pressure on a nerve (such as sitting with crossed legs or leaning on an arm). However, persistent or recurrent pins and needles may signal an underlying medical condition.

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Common Causes

• Temporary causes (usually harmless):

  • Pressure on nerves or reduced blood flow (e.g., sitting awkwardly, crossing legs, sleeping on an arm)

  • Cold temperatures

  • Anxiety or hyperventilation

• Medical conditions:

  • Diabetes – peripheral neuropathy due to nerve damage from high blood sugar

  • Vitamin deficiencies – especially B12 deficiency

  • Carpal tunnel syndrome – compression of the median nerve in the wrist

  • Sciatica – irritation or compression of the sciatic nerve

  • Multiple sclerosis (MS) – nerve damage from demyelination

  • Stroke or transient ischemic attack (TIA) – sudden onset of tingling or numbness, especially on one side

  • Poor circulation or peripheral artery disease (PAD) – reduced blood flow to limbs

  • Infections affecting nerves (e.g., shingles, Lyme disease)

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Treatment Options

Treatment depends on the underlying cause:

• Lifestyle/temporary causes:

  • Change position and move around to restore blood flow

  • Avoid prolonged pressure on limbs

  • Gentle stretching and exercise to improve circulation

• Medical treatment (based on cause):

  • Diabetic neuropathy: good blood sugar control, medications such as pregabalin, duloxetine, or gabapentin

  • Vitamin B12 deficiency: B12 supplements or injections

  • Carpal tunnel syndrome: wrist splints, physiotherapy, corticosteroid injections, or surgery if severe

  • Sciatica/nerve compression: physiotherapy, anti-inflammatory medicines (ibuprofen, naproxen), or surgical intervention in severe cases

  • Multiple sclerosis: disease-modifying therapies and symptom management

  • PAD: lifestyle changes, antiplatelet medicines (aspirin, clopidogrel), or vascular surgery if severe

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When to Seek Urgent Medical Help

See a doctor immediately if:

• Pins and needles occur suddenly, especially on one side of the body (possible stroke/TIA)

• Tingling is associated with weakness, paralysis, or loss of bladder/bowel control

• Persistent or worsening symptoms without clear cause

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Medications Commonly Used

• For nerve pain: gabapentin, pregabalin, duloxetine, amitriptyline

• For inflammation/pain: ibuprofen, naproxen (short-term use)

• For underlying deficiencies: vitamin B12 or folate supplementation