Pins and needles (paraesthesia)

What are pins and needles?

The medical name for pins and needles is paraesthesia. It is a sign that sensory nerves in the area of the tingly sensation are being irritated. This irritation may be the result of disease or damage to the nerves themselves, damage to the blood supply, or disease of the surrounding tissues, such as arthritis, which ultimately affects the nerves.

Causes and risk factors

Pins and needles become more common as a complaint as people get older because it becomes increasingly likely that some sort of disease may irritate the nerves. Another common problem among older people is arthritis, which can interfere with both nerves and blood supply.

Other causes include:

• Nerve damage - almost any condition that can damage nerves may cause pins and needles. In these cases the tingling can be extremely unpleasant, with a raw burning character.
• In younger people, multiple sclerosis often begins with a prolonged episode of pins and needles for which no other cause can be found.
• Vitamin deficiencies - although few people in the UK have severe vitamin deficiencies, older people are prone to a poor diet and minor deficiencies. Abuse of alcohol is another cause of vitamin deficiency.
• Metabolic disorders, ranging from diabetes to changes in blood chemistry that occur during a panic attack. Both these examples are common causes of tingling in the fingers.
• Poisoning, especially with heavy metals.
• Infections.
• Poor blood supply - irritation of the nerves may result when their blood supply is reduced or cut off, either by chronic disease such as atherosclerosis, intermittently (for example, in a condition called Raynaud's phenomenon where the artery goes into spasm) or acutely by sudden compression of the arteries (a classic problem is when someone gets drunk and falls asleep with their arm hanging over the edge of a chair).

Tingling is a sign that the nerve is still alive, if under threat. When the nerve dies the tingling should stop. So it may be a good warning sign to take action.