The definition of paresthesia is one that includes symptoms of tingling and numbness. The feeling of paresthesia is that of the sensation of prickling or burning located commonly in the limbs, but it can also affect other body parts. The feeling occurs with no warning and is often described as tingling, skin crawling, numbness or itching. The “pins and needles” feeling is a very familiar sensation that is felt by people who have had their legs or arms fall asleep, which is due to those people being in certain body positions that create localized pressure on the nerves. Once the pressure is alleviated, the sensations of numbness and tingling slowly disappear and the person who experienced these sensations will just move on with their day. Some people, however, have chronic paresthesia, and those regularly recurring symptoms are a result of some type of underlying neurological disease or very traumatic nerve damage that impacts the nervous system. The typical causes of chronic paresthesia could be a major stroke or transient ischemic attacks (mini-strokes), multiple sclerosis, transverse myelitis, and encephalitis as well as vascular lesions or tumors that put too much pressure on the spinal cord or brain. In less severe situations, nerve entrapment syndromes can cause paresthesia and pain, due to the damage caused to peripheral nerves. Carpal tunnel syndrome is an example of the latter syndromes.1 One much less common but not unheard of sensation, which still meets the definition of paresthesia, is “formication, the sensation of bugs crawling underneath the skin”. As noted before, paresthesia can be transient or chronic. For the patients with chronic paresthesia, poor circulation could also be the culprit. Patients with peripheral vascular disease and atherosclerosis are at risk. The paresthesia definition of symptoms can apply to patients with malnutrition, vitamin deficiency, mercury poisoning, and metabolic disorders, such as hypothyroidism, hypoparathyroidism, and diabetes. In addition, nerve damage also triggers paresthesia, such as neuropathy, frostbite, and Lyme disease. Chemotherapy and benzodiazepine withdrawal can also cause the symptoms, as may autoimmune diseases such as lupus or multiple sclerosis. For those with the transient paresthesia, cold sores, panic attacks or have a pinched nerve can cause symptoms. There are also several other conditions that might lead to paresthesia, such as mood disorders, dehydration, Guillain-Barre syndrome, immunodeficiency, migraines, rabies, shingles, scorpion stings, and many others.2
Medical Treatments of Paresthesia
One of the previously mentioned causes of paresthesia, multiple sclerosis, is a seriously disabling and progressive disease of the central nervous system. Eventually, MS will force the nerves to deteriorate or, at least, suffer severe and permanent damage. Numbness or weakness in the limbs is one of the earliest symptoms of multiple sclerosis, which means that a patient with chronic paresthesia should consider seeing a doctor if there is no other obvious explanation for why the tingling and numbness is regularly occuring.3 Another previously mentioned source of paresthesia is Guillain-Barre syndrome. This syndrome is a rare autoimmune disorder in which the healthy nerve cells in the peripheral nervous system are attacked by the immune system itself. While the specific cause of multiple sclerosis is unknown, Guillain-Barre syndrome is usually triggered by some type of infectious illness, like an infection in the lung or stomach flu. Guillain-Barre syndrome starts with weakness, numbness, and tingling but it can eventually lead to paralysis. The syndrome is difficult to diagnose initially because it shares so many similar symptoms with other neurological disorders and conditions.4 Doctors try to find the source and severity of the paresthesia before recommending treatment. A nerve conduction study may be ordered, and a CT scan can allow the doctor to rule out a few of the causes that might originate from the central nervous system, for example. Some patients may need palliative care, such as topical creams, while others will be prescribed medications.5 The treatment options that are provided will also depend on the types of symptoms that occur. Patients could experience itching, tingling, dysarthria, numbness, footdrop, ocular dysmetria, muscular atrophy, crawling sensations, limbs “falling asleep”, or restless legs syndrome. It is important to accurately diagnose the cause so that the underlying condition can be managed. Focusing primarily on treating the symptoms of paresthesia will do nothing for the patient in the long term unless the cause is identified and treated. For patients with diabetes or chemotherapy complications, treatment could be used to also provide symptom relief, such as anti-inflammatory medications. For difficult paresthesia, a doctor might prescribe a low dose of amitriptyline, an antidepressant medication, to help with pain perception. In severe cases of paresthesia, a patient might be prescribed codeine or other such derivatives of opium.6 Some researchers are looking into the growth factor that is found in human nerves as a treatment option for the possibility of providing a boost to help heal nerve degradation and to restore those nerves which have already been damaged.7
At Home Treatment Options
Patients concerned about the side effects of certain medications may opt for alternative treatments, such as nutritional therapy. This therapy might include B complex vitamins, such as B12. It should be noted, though, that B6 should be given with caution as an overdose of this vitamin can itself cause paresthesia. Patients with paresthesia should avoid the consumption of alcohol and caffeine. Caffeine is dehydrating to the body and impedes blood circulation. Too much alcohol can also damage nerves create a condition known as alcoholic neuropathy. Other treatment options include massage and acupuncture. Even self-massage, with certain essential oils that are safe for topical application, can be useful. Capsaicin may also provide relief, in the form of topical ointments. Capsaicin contains “the substance that makes hot peppers hot”. Patients might also wish to wear loose-fitting shoes and clothes.8 While seeking an experienced acupuncturist or massage therapist may be preferred, some patients could find relief in the short term with self-massage by using oils such lavender, chamomile, peppermint, sandalwood, and marjoram.9 Coconut oil is another option for self-massage. The patient should use their fingers to put firm pressure on the area that is symptomatic of paresthesia, repeating the massage a few times a day for a few days to find out if it provides any relief. Another at-home option is a warm compress, as heat increases the blood supply. With increased blood flow comes a means of pain relief through flushing out toxins caused by inflammation. The patient should use a clean cloth that has been soaked in warm water and wring out excess water before applying the compress to the affected area for a few minutes. A warm bath could produce the same result.10
There are various chiropractic treatment options for paresthesia, including chiropractic adjustments, vibration therapy, concentrated oxygen, electrical muscle stimulation, and thermal modalities. With chiropractic care, the goal is to treat the underlying condition and to help the neuropathy heal on its own without the risk of side effects from medications or surgeries. Additionally, patients need to get other medical conditions under control, such as controlling blood sugar with diabetes and eating a healthy diet with “fruits, vegetables, whole grains and lean protein”. Strict vegetarians and vegans might want to consider B-12 supplements. Their regular diet is fine, but B-12 is one thing that is more difficult to get from an animal-free diet without the help of natural supplements. Regular exercise may also be useful, and patients who smoke should quit for a variety of health reasons beyond just aggravating their paresthesia. Chiropractors often have recommendations for the types of stretches and exercises that their patients can try at home in between treatment visits. They could also suggest a local massage therapist for further relief, as massage therapists and chiropractors often work very well together with their complementary treatments.11 The patient could start by just walking for about thirty minutes every day, slowly increasing their pace each day to increase heartrate without overexertion. Swimming, biking, and other exercises that work the cardiovascular system are also helpful.12 In a case study, a patient had idiopathic, intermittent hemiparesthesia and received chiropractic treatments of cold laser therapy, vibration therapy, and manipulation. The 24-year-old woman had reported positive outcomes from the treatments.13 NUCCA chiropractors also treat paresthesia with a procedure that is said to realign the spine gently “to a balanced, unstressed position, immediately relieving pressure from the spinal nerves”. These chiropractors work to resolve the misalignment, which is believed to be the underlying cause of the problems.14
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