Paresthesia: What It Is and What Causes It

Medically Reviewed by Jabeen Begum, MD on May 03, 2024
Written by Camille Noe Pagán, Kendall K. Morgan
6 min read

Paresthesia is that "pins and needles" feeling that you've probably had at some point. Maybe you fell asleep with your arm pinned under you, or you kept your legs crossed too long. You might refer to it as your body part "falling asleep." Paresthesia is the sensation that comes after that when you move and release the pressure that you had on your blood vessels or nerves.

Usually, paresthesia is painless and harmless. The most common form is transient paresthesia, It means that the feeling is temporary or doesn't last long once your blood gets flowing again.

But sometimes, it can be a sign of a more serious medical problem. If your tingling feeling lasts longer or happens often, it could be a sign of a condition, such as carpal tunnel syndrome or cubital tunnel syndrome. It could also be a sign of trouble with your circulation or nerve damage.

Paresthesia vs. neuropathy

Neuropathy is any disease or condition that affects your nerves. Sometimes, the pins and needles feeling of paresthesia can be a sign of neuropathy. But more often, paresthesia is transient and unrelated to a chronic condition.

To tell the difference, consider that paresthesia is just one possible symptom of neuropathy. Neuropathy can come with many other symptoms, including:

  • Numbness
  • Throbbing or sharp pain
  • Pain from things that shouldn't cause pain, such as standing on your feet
  • Falling or other signs that you lack coordination
  • Weakness in your muscles
  • Feeling like you have gloves or socks on when you don't
  • Trouble moving

You'll usually feel paresthesia in your hands, arms, legs, or feet. But it can happen in other areas of the body as well.

People with paresthesia could feel:

Paresthesia happens because of pressure on your nerves and blood vessels. When that pressure is gone -- for example, when you uncross your legs -- the feeling goes away, usually in just a few minutes. You can also get a feeling like this if you bump your elbow to "hit your funny bone." Other causes of transient paresthesia include:

  • Dehydration
  • Hallucinations that feel like bugs on your skin
  • Hyperventilation
  • Migraines
  • Panic attacks
  • Raynaud's syndrome
  • Seizures
  • Whiplash

In some cases, paresthesia doesn't go away. Or if it does, it comes back regularly. That's called chronic or persistent paresthesia, and it can be a sign of a medical condition or nerve damage. Several things can cause chronic paresthesia.

Circulatory causes

If your blood isn't flowing the way it should, it can affect your nerves and the signals they send to your brain. If you have a syndrome or other condition that affects your circulation, paresthesia may be one symptom.

Nervous system causes

Conditions affecting your nerves also can give you the same tingling feeling. Neurological conditions that may cause paresthesia include:

  • Ataxia-telangiectasia
  • Brain tumor
  • Brain bleeds
  • Charcot-Marie-Tooth disease
  • Herniated disks
  • Nerve damage from frostbite or burns
  • Head injury or trauma, including concussions or traumatic brain injuries
  • Neuralgias
  • Peripheral neuropathy
  • Pinched nerves
  • Spinal stenosis
  • Strokes

Metabolic and endocrine causes

Some hormonal or metabolic conditions may also cause pins and needles. These include:

  • Neuropathy from diabetes
  • Electrolyte imbalances
  • Low blood sugar
  • Low function of your parathyroid
  • Low function of your thyroid
  • Menopause

You may also get it from deficiencies in vitamins such as:

  • Vitamin B1 (thiamine)
  • Vitamin B5
  • Vitamin B6
  • Vitamin B12

Autoimmune and inflammatory diseases

When your immune system attacks your nerves or causes swelling, you may get paresthesia as a symptom. Conditions that can cause this include:

  • Fibromyalgia
  • Lupus
  • Multiple sclerosis
  • Rheumatoid arthritis
  • Sjogren's syndrome
  • Transverse myelitis

Infectious diseases

Infections that affect your nerves or brain may cause paresthesia. These include:

  • Encephalitis
  • Meningitis
  • Guillain-Barré syndrome
  • Leprosy
  • Herpes simplex virus
  • Shingles
  • HIV
  • Lyme disease
  • Syphilis

Toxins

Toxins that can affect your nervous system and cause a tingling feeling include:

  • Arsenic
  • Carbon monoxide
  • Lead
  • Mercury
  • Alcohol
  • Radiation
  • Venomous bites or stings

Medications

Certain medications for conditions such as HIV and cancer can affect nerve function and lead to paresthesia. It's more likely if you have other risk factors. 

Medications that can cause nerve damage and paresthesia include:

  • Chemotherapy
  • Antimicrobials
  • Cardiovascular drugs
  • Psychotropic drugs
  • Anti-seizure drugs

Pregnancy

When you're pregnant, you may get paresthesia. It can happen due to one of many disorders that affect peripheral nerves. Some conditions that may cause this in pregnancy include:

  • Neuropathies
  • Neuralgias
  • Bell's palsy
  • Diabetes
  • Vitamin deficiency
  • Genetic syndromes

Other causes

Many things can cause the "pins and needles" feeling. Some other possible causes include:

  • Nerve compression syndromes
  • Amyloidosis
  • Porphyria
  • Uremia
  • Sciatica

If you have paresthesia that doesn't go away or happens a lot and you don't know why, see your doctor to help you find the cause. It could be related to a more serious health condition.

Several things can raise your chances of paresthesia, including:

Certain medications can also cause paresthesia in some people. These can include:

If you think a medicine you take might cause your paresthesia, talk with your doctor. They may be able to change your treatment or your dose.

In many cases, paresthesia goes away on its own. But if any area of your body regularly goes numb or gets that "pins and needles" feeling, talk to your doctor. They'll ask about your medical history and do a physical exam.

They also may recommend certain tests to figure out what's causing your paresthesia. These might include an X-ray, blood test, or an MRI scan. An MRI uses powerful magnets and radio waves to make detailed images of certain areas of your body.

Transient paresthesia will usually go away on its own in a few minutes as you move around. But the treatment for chronic or more persistent paresthesia will depend on what's causing it. Treating the cause will usually make paresthesia go away or make it happen less often. Talk with your doctor about which treatments can help you.

Paresthesia is the name for that tingling, "pins and needles" feeling you get when you sit the wrong way or sleep on a limb and then move. This type isn't a big concern and goes away on its own. But many health conditions can also cause this feeling if they damage your nerves. If you have chronic or persistent paresthesia, you should see your doctor to find out why and how to treat it.

How do you confirm paresthesia?

There's no test for paresthesia, as it's just a sensation in your body. But if you're having trouble with this happening a lot or it's getting worse, your doctor may want to test how your nerves are working or look for other possible causes, such as hypothyroidism, diabetes, arthritis, vitamin deficiencies, or other conditions.

What are the red flags for paresthesia?

Paresthesia usually isn't a sign of a serious health condition. Many times, it's transient and just goes away. But paresthesia can be a red flag of more serious conditions in some cases. For example, persistent paresthesia can be a sign that a head and neck or other cancer is spreading along a nerve. If you have paresthesia and are worried about the cause, see your doctor.