Pins and needles

What can pins and needles be a sign of?

Numbness and pins and needles occur when you lose normal sensation in an area of the body. This happens because pressure cuts off the blood supply to nerves that send signals about sensation to the brain. This can affect any body part- eg, hands, feet, face.

This list does not include all the possible causes of numbness/pins and needles but lists some of the more common causes, including:

Pressure

Wearing tight shoes or sitting on your foot can give you a numb foot or leg or cause pins and needles. This kind of numbness has an obvious cause, gets better when the pressure is removed and doesn't cause any further problems.

Trapped nerve

Numbness or pins and needles can also be due to a trapped nerve.

• A slipped disc or back problem can put pressure on a nerve that travels from your spinal cord, down your leg and into your toes.

• A trapped nerve in the neck can also cause numbness or pins and needles anywhere from your neck, down your arms and into your fingers.

• Carpal tunnel syndrome is a trapped nerve at the wrist, giving you pins and needles and pain in the hand and loss of grip - this can be associated with rheumatoid arthritis. Around 6 pregnant women in 10 may experience this pregnancy-related cause of pins and needles in the hand.

• Other examples are thoracic outlet syndrome and spinal stenosis.

Diabetes

Diabetes can damage small blood vessels that supply nerves in fingers and toes. This can cause tingling in hands and feet, pain or numbness in the hands and feet (peripheral neuropathy). Being unable to feel anything in your hands and feet can be dangerous, as you may stumble, drop things or not realise when you are touching something hot.

Injury

Damage to nerve endings in fingers or toes can be the result of an injury. People who use vibrating tools a lot may also develop nerve damage and may experience pins and needles in fingers or the hands.

Medicines

Some medicines can cause nerve damage. It is usually reversible when the medicine is stopped. The medicines include:

• Some chemotherapy medicines used to treat breast cancer and lymphoma.

• Antiretrovirals used to treat HIV/AIDS (generally the older drugs rather than the ones used these days).

Diseases that damage nerves

Many medical conditions can damage the nervous system and cause areas of numbness or pins and needles. These include:

• Stroke.

• Multiple sclerosis.

• Brain tumours.

These conditions are serious but relatively rare and will all cause other symptoms in addition to the numbness/pins and needles.

Alcohol

Alcohol misuse can damage nerves.

Vitamin deficiency

Vitamin B12 deficiency is common among very elderly people, vegans and people with a condition called pernicious anaemia. The lack of vitamin B12 causes anaemia and nerve damage.

Treatments

Treatment will depend on the likely cause of your numbness/pins and needles. You may be asked to keep a diary of the circumstances in which they happened. Most cases will be managed by your GP but you may be referred to a hospital for further investigation and treatment.

Immediate

• Loosen any tight clothing/shoes.

• Get up and shake the limb if you have been sitting/leaning on it for a long time.

Medium-long term

• Minimise neck/back problems by:

  • Avoiding lifting heavy weights.

  • Avoiding repetitive movements.

  • Taking regular breaks at work.

  • Avoiding poor posture - consider doing yoga or Pilates.

• Control diabetes, if you have it, with diet, medication, avoiding obesity and having regular check-ups.

• Avoid excess alcohol.

• Avoid vitamin B12 deficiency by eating a mixed diet or have a blood test to check whether you need supplements.

Driving is not a problem for simple numbness/pins and needles but restrictions apply if the situation is more complicated or if diagnosis is less clear. If in doubt, contact the Driver and Vehicle Licensing Agency (DVLA).

You should dial 999/112/911 to call an ambulance if you notice you have a loss of power down one side of your body (a possible stroke).

If the attacks of numbness/pins and needles recur or you do not make a complete recovery, you should see your doctor soon to seek medical information. You should also go if you have signs of a neurological disease (worsening loss of power or sensation in part of the body, difficulty walking, falls).

In most persistent cases, you should first see your GP. If you have lots of attacks, or you hurt yourself because of the numbness, your GP may want you to see a specialist.

Can pins and needles be dangerous?

This depends on the underlying cause.

Persistent numbness of the feet can lead to falls which can be serious in the elderly.

Persistent numbness of the hands can affect your grip and make you prone to burns and injury.

You can get numbness/pins and needles by putting pressure on a part of your body, like wearing tight shoes or sitting on your foot. People with back pain, those who have diabetes or people who use vibrating tools are more prone to develop the problem.

The doctor will want to know more about the length of the periods of numbness/pins and needles to aid diagnosis and treatment. Is there any obvious cause? Have you started new medication? How much alcohol do you drink? Do you have diabetes? The answers will help the doctor to make a diagnosis.

Your doctor will examine you. They will check your heart, including your blood pressure and pulses in your wrists and feet. Your nervous system will be checked and you may be asked whether you can feel a pinprick or other sensations in your limbs. You may be asked to have a blood test to check for diabetes, anaemia and vitamin B12 levels. Further tests of your heart and nervous system may be necessary.

You will need to find the underlying cause and try to address it if possible.

Pressure on nerves, due to back and neck problems, is very common.

Diabetes is the most common cause of persistent numbness/pins and needles.