Paresthesias

What are Paresthesias?

Paresthesia symptoms of tingling and numbness can be bothersome, or they could be signs of larger problems. Simply put, paresthesia refers to a tingling, pricking, burning, or tickling feeling on the skin “with no apparent long-term physical effect”. It can come and go or be a chronic phenomenon. The most common one is the “pins and needles” feeling of a body part “falling asleep”. Paresthesias can feel like tingling in the feet, tingling sensation in the head, tingling and numbness in the hands, numbness on the right side of the body, left side numbness, or numbness in the arms and legs, for example. The legs, arms, hands, and feet are the parts of the body most commonly affected by transient paresthesias. These sensations are generally caused by the blood supply becoming temporarily restricted to the nerves, such as leaning or resting on the limbs for too long. Panic attacks and hyperventilation can also cause transient paresthesia. Poor circulation and problems with neuron functioning may cause chronic paresthesia. Atherosclerosis, peripheral vascular disease, malnutrition, vitamin deficiency, thyroid issues, and diabetes may all be culprits in this condition. In addition, patients with inflammation and joint conditions such as carpal tunnel syndrome, rheumatoid arthritis, psoriatic arthritis, compressed nerves, poor posture, and whiplash can also have chronic issues. Neuropathy could be triggered by Lyme disease, frostbite, autoimmune diseases (e.g., multiple sclerosis, lupus), chemotherapy, or transient ischemic attack (TIA). Demyelinating diseases and shingles may also cause paresthesia.¹

Treatment Options

Treatment for paresthesia depends on the cause. If it is transient, then just removing the pressure on the nerve will suffice. Chronic conditions may require additional diagnostic tests before treatment.² Paresthesias may be caused by nerve entrapment, such as with carpal, cubital, and tarsal tunnel syndromes and meralgia paresthetica. In some cases, dietary changes and nutritional supplementation may be advised.³ Medical doctors may prescribe medications to deal with symptoms, such as anti-inflammatory or antidepressant drugs. Medications carry risks and side-effects. Chiropractic treatment could be beneficial for cases of nerve entrapment. Chiropractors seek to address the underlying cause of the paresthesia, such as “pressure on the spinal nerves” that results from “long standing misalignments” which have contributed to “degenerative disc and joint disease” as well as inflammation. Realigning the spine can relieve nerve pressure and the load on the discs.⁴ Some patients may benefit from B-complex supplements. Others may find relief from capsaicin (a topical ointment), acupuncture, or massage. Wearing comfortable and loose-fitting clothing and shoes could also provide symptom alleviation.⁵

Yoga and Tai Chi

Yoga is a great exercise for the patient to strengthen their physical and mental self and gain an increased awareness of their own body. Those who have a better sense of themselves may be able to identify abnormalities more quickly. However, patients who engage in yoga, or any exercise, should always keep in mind that there is no merit to working themselves too hard or trying to work through impeding symptoms. Some more difficult yoga poses could aggravate a patient’s paresthesia, as some positions do put unusual pressure on the body when they are first learned. A patient who tries a new pose should not attempt to hold the pose for too long, until they become accustomed to it. The tingling and numbness should not be ignored until pain occurs, and the patient should instead slowly come out of the position and rest at least until the regular blood flow returns. Patients should try to gradually work their way towards learning new poses. Some might find that it is not the pose but instead the temperature of the room that is causing the numbness, in which case wearing socks and regularly massaging the feet during yoga could help. Regular hydration is important to be sure that the cause of the tingling is not due to an electrolyte imbalance. For those patients who know that their paresthesia occurs more regularly than their yoga sessions, they might continue to use yoga as a form of exercise while also seeking treatment if their doctor approves of this form of exercise.⁶ Tai chi is another great exercise that might be helpful. In one study, a group of individuals who had peripheral neuropathy tried tai chi for six months. Improvement was seen over the course of the study, and the patients’ plantar neuropathy began to have reported cases of some increase in sensation. The study found tai chi to be an effective and safe form of intervention for those with peripheral neuropathy.⁷

Acupuncture for Paresthesia

Acupuncture could be another treatment option for peripheral neuropathy. In more minor cases of paresthesia, it might even be the only treatment necessary. If there is a more serious underlying condition that is causing the paresthesia, the patient should also seek treatment from a doctor. Acupuncture is meant to promote circulation and improve the function of nerves and reduce pain. The acupuncturist might also use transcutaneous electronic nerve stimulation in addition to acupuncture. The TENS unit blocks pain signals by using very small amounts of electricity applied to points on the patient. Acupuncture treatment, despite what it might look like, does not provide the patient a lot of negative physical feelings. The needles are very thin, and there might be slight discomfort upon their insertion, but this discomfort will fade once the needles are in place. Some patients even fall asleep during the up to thirty-minute-long sessions. One study has shown that 34 out of 46 diabetic patients with peripheral neuropathy began to feel significant symptomatic improvement after six acupuncture treatments. The remainder just required further sessions. Out of all 46, only seven of the patients experienced complete relief of their symptoms. Another, larger study used groups of patients that either received acupuncture or received placebo needles. Though there were no significant reported differences in pain following the trial, the researchers concluded that the standardization of the treatments rather than the usual, individualized approach to acupuncture might have affected the results differently. Sometimes, studies done on acupuncture produced mixed or neutral results, so it is up to the patient whether they wish to consult an acupuncturist. Patients who choose to pursue acupuncture should find a local practitioner who is experienced and well-trusted by a community of patients.⁸