Paresthesia: what it is, causes and treatment

Have you ever wondered why you feel tingling in your arm when you sleep on it?

These are common sensations that almost all of us have experienced at some point. Its answer lies in how the body receives and processes stimuli from our environment: through the central nervous system.

In this article we will explain everything you need to know about this uncomfortable sensation that, in most cases, is a benign phenomenon.

What is paresthesia?

Paresthesia is the tingling, burning, numbness, or tingling sensation that the person may experience when sitting cross-legged for a long time or hitting a nerve.

Under normal conditions, the stimuli captured by our body are sent, through afferent somatic nerve fibers, to the spinal cord and brain.

Conversely, a response can be sent from the latter two to the rest of the body (e.g., the limbs) by efferent fibers.

When a nerve is compressed, the region of skin that corresponds to it is affected.

Normally, paresthesia occurs in the arms, hands, legs, and feet. Depending on the severity and duration of the paresthesia, motor functions may be compromised.

Causes of paresthesia

Depending on the cause, paresthesia can be transient and short-lived, as well as prolonged or intermittent over days or weeks.

Chronic paresthesias, in prolonged periods of time, are known as Bernhardt’s paresthesia.

cerebrovascular accidents

One of the causes of prolonged paresthesia is of vascular origin, originating in the central nervous system.

Cerebrovascular accidents (ACV) occur due to insufficient blood supply to the brain that leads to ischemia (lack of oxygen) and later to necrosis.

Paresthesia, together with a generalized sensory deficit, clinically characterize strokes. Infarcts in the diencephalon or midbrain can cause paresthesia as well.

Cheiro-oral syndrome is characterized by paresthesia and sensory deficit of the hands and fingers on the same side of the lesion, caused by multiple small infarcts in the medulla and cerebral cortex.

Transient ischemic attacks

A transient ischemic attack is an episode of neurological dysfunction of vascular origin, without evidence of infarction on imaging techniques.

Transient ischemias occur when the flow of blood is obstructed, but not enough to lead to tissue death.

They can be caused by thrombi (blood clots), emboli , lesions in blood vessels, or any impediment to the passage of blood.

It can present as a loss of sensation and general weakness on one side of the body (hemiparesthesia), which usually does not last more than an hour.

Multiple sclerosis

Multiple sclerosis (MS) is a chronic, autoimmune nervous disorder caused by demyelination of nerve fiber axons.

The most common symptoms are pain and sensory deficit. A study by the European Journal of Neurology published the results of a series of neurological examinations and interviews with 142 MS patients.

105 and 93 people reported sensory deficits and pain, respectively. The most frequently described symptoms were paresthesia, neuralgia, and deep muscle pain.

Important risk factors are the consumption of alcohol or tobacco.

Transverse myelitis

Transverse myelitis is inflammation along a segment of the spinal cord. It can occur due to autoimmune, inflammatory or infectious causes.

One of its most common symptoms is paresthesia, pain, and sensory disturbances. The symptoms can last from hours to days and even worsen over the weeks.

Encephalitis

Encephalitis is a general term for inflammation of any part of the brain. It can originate from multiple causes and cause all kinds of neurological conditions.

This can cause deficits in memory, attention, motor skills, sensitivity and much more.

Certain infections, such as SARS-CoV-2019 , cause meningoencephalitis that leads to severe headaches and paresthesia on one side of the body.

Carpal tunnel syndrome

Carpal tunnel syndrome is the entrapment or compression of the median nerve at the wrist, causing pain, paresthesia, and sensory deficits in the affected hand.

It represents a type of peripheral neuropathy. That is to say, affections, not of the brain or spinal cord, but of the nerves that pass through all parts of our body.

One possible cause may be inflammation of the surrounding synovial capsules that press on the nerve.

The most frequent symptoms are paresthesia and pain, which are aggravated at night or when performing certain kinds of physical activities (for example, sweeping or lifting buckets).

Tumors

A large enough tumor mass, or near a nerve or in the brain mass, can cause symptoms of all kinds.

Paresthesia may be accompanied by headache, weakness, nausea, vomiting and blurred vision are very suggestive symptoms of a tumor or metastasis.

Cavernous angiomas, syringomyelia, or tumors in the somatosensory cortex are some examples.

Rheumatoid arthritis

Rheumatoid arthritisis a chronic, degenerative inflammatory condition of the joints and surrounding tissues.

Spinal conditions are one of the most dangerous skeletal complications for the patient. Erosion of bones and joints can compress the spinal cord, causing myelopathy.

Pain, paresthesia, and weakness are common manifestations of these pathologies.

Diabetes

Diabetic neuropathies are frequent complications in diabetic patients whose glucose has not been controlled.

These disorders increase the morbidityand mortality of the patient. They cause pain, numbness and even ulceration of the compromised member.

Metabolic dysfunction is hypothesized to cause damage to regional blood circulation and nerves.

symptoms of paresthesia

Paresthesia can manifest itself in multiple ways. Among them, we leave you some of the most frequent symptoms.

Tingle

Tingling is the most common description given to paresthesia, also known as formication, whose etymological origin comes from formica, which means ant.

Tingling corresponds to a transient variant of paresthesia.

They can result from uncomfortable positions, such as crossing your legs or standing on your legs for prolonged periods of time. Sleeping on one arm can cause a feeling of discomfort upon waking.

Pangs

Tricks are another variant of paresthesia, described as “needle sticks,” which can be mild, moderate, or even severe, depending on the duration and intensity of the paresthesia.

Burning sensation

Certain patients may report burning during paresthesia. A possible sign of pain of ischemic origin due to vascular problems that affect not only the nerve.

The burning sensation is more prominent in those chronic paresthesias due to mechanical causes (prolonged compression of a nerve), vascular, inflammatory, etc.

numbness

Numbness occurs when the nerve is compressed for a long time. If a person is seen sitting cross-legged for a long time, they will have difficulty moving when they get up.

On the other hand, numbness can also be a sign or harbinger of neurological disorders, especially for no apparent reason. Imaging techniques, performed by specialists, are warranted to find the cause.

loss of sensation

An afferent somatic nerve collects all sensory stimuli from a specific area, called the dermatome.

If the function of the nerve or the processing of sensory input is impaired, the sensation of the area is lost.

Depending on the cause and its location, the loss of sensation can be restricted to one area (the face, for example, in paresthesias of The Trigeminal Nerve ) or large areas (extremities).

Muscle weakness

Conditions of the central nervous system or peripheral nerves can generate not only sensory loss, but also motor loss.

An example of the first would be a compression of the cerebral cortex by a tumor, generating neurological dysfunctions that can range from mild, moderate to severe.

An example of the second would be the thoracic outlet syndrome, where the vessels and nerves that go to the arms are compressed for some reason. This generates paresthesia, pain and muscle failure.

Respiratory problems

Certain conditions of the nervous system due to compression, infections, inflammation or poor vascularization or even low calcium levels.

These can generate, in addition to paresthesia, breathing problems. Especially if the problem is located at the level of the brainstem.

The nervous system controls breathing and the muscles involved in it, highlighting that respiratory problems are not symptoms of paresthesia but are closely related to it, especially if it is chronic paresthesia.

Incontinence

Urinary incontinence can be defined as any involuntary loss of urine.

Said urinary incontinence finds in its causes the intrinsic deficiency of the sphincter of the bladder, causing the involuntary output of urine, this may be due to a malfunction or compression of certain nerves.

Risk factors for urinary incontinence include heart disease, diabetes mellitus, Parkinson’s disease , stroke, various drugs, or smoking.

However, as in the previous case, urinary incontinence is related to paresthesia but is a symptom of it.

How to treat paresthesia?

Paresthesia is a tingling sensation that is experienced anywhere in the body, is usually painless, can cause numbness and is associated mostly with transient events.

We can say that almost all of us have experienced it, in the arms and legs by placing heavy objects on the extremities that generally stop in minutes.

On the other hand, we enter chronic paresthesia, which can mean that there is a neurological problem or nerve injury.

The appropriate way to treat paresthesia depends on the affected site, the latent cause and its duration.

Medications under optional prescription

Certain medications can help in the treatment of chronic paresthesia, since, as we mentioned above, transient paresthesia spontaneously disappears in minutes.

Said transient paresthesia can be treated with methods related to or mostly leaning towards the area of physiotherapy.

However, those paresthesias whose causes are neurological, the treatment will depend on the diagnosis made by the specialist.

The use of certain anticonvulsants can generate paresthesia, since it is usually a side effect of one of them. However, side effects are being reduced in newer anticonvulsants such asgabapentin .

Under certain conditions, the anticonvulsant gabapentin helps to relieve paresthesia as it has an effect on neutralizing pain caused by damaged nerves.

Exercising

Physical exercise can be defined as an activity that involves movement of the body, consuming energy as muscle contractions occur, for example, running or walking.

It has multiple benefits with a positive impact on our health, on the mental and physical state of people, since physical exercise helps to regulate our body systems to a certain degree.

Among them, the cardiovascular, musculoskeletal and respiratory systems. Having favorable effects in reducing the development of chronic diseases, including cardiovascular conditions, diabetes mellitus and chronic respiratory failure.

Knowing that paresthesia can occur in people with diabetes, cardiovascular problems, this physical exercise helps us stay healthy by reducing risk factors.

Massages in the affected area

We can say that massages represent one of the oldest therapeutic tools used to relieve pain or numbness.

The massage in the affected area serves to alleviate or eliminate the tingling sensation produced in the paresthesia, allowing a good sliding of the tissues, relaxing the muscles, in turn the nerves that may be compressed.

The main objective of massages in the affected areas is the recovery of optimal or normal function, for example of the legs, and also in the rehabilitation of injuries.

Muscle stretching

Muscle stretching is relevant in physical activity attributing many benefits.

From high performance athletes, therapeutic activities or simply walking, cycling, jogging or running, it is essential to perform a stretching routine to maintain healthy muscle activity.

These muscle stretches should be done both before and after exercise, as they help stabilize the muscle by keeping it flexible and thus preventing injury.

Its purpose is to reduce muscle tension, trying not to injure a nerve that could cause paresthesia events, or simply the tingling sensation due to not previously stretching the muscles.