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Pins and Needles – What could they mean?

Pins and needles

Paraesthesia is the term given to pins and needles and other abnormal sensations such as burning, crawling, cold, hot and tingling when there is no reason for these to be felt. This is a common complaint we hear in practice and is a sign of altered nerve function.

What is happening here is the nerve is misfiring due to the damage being done and this travels to the brain and is felt as pins and needles. This can happen anywhere along the path of the nerve and the type of sensation will vary depending on what type of nerves are involved and the intensity and duration will vary depending on the injury.

There is a long list of potential causes of nerve damage and subsequent pins and needles, some of them systemic such as nutritional deficiencies (B12, Folate) alcoholism, diabetes, hypothyroidism, multiple sclerosis, guillain barre syndrome, neurotoxic medications for example, and some of them are local problems related to either trauma and inflammation and/or compression. Examples of these are carpal tunnel syndrome in the wrist or disc herniation causing compression of a nerve as it exits the spine in the lower back or even sleeping with the arms tucked up which compresses the nerves to the hands. The key with these local causes is to remove the inflammation and or compression of the nerve.

Nerve stretching and mobilisation has been shown to help improve nerve function and this can be combined with lifestyle modifications to decrease the repetitive strain to the nervous system. The key in any case is finding the right cause so the correct treatment or investigations can be performed.

Walsh MT. Upper limb neural tension testing and mobilization. Fact, fiction, and a practical approach. Journal of hand therapy : official journal of the American Society of Hand Therapists. 2005;18(2):241–258

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