Paraesthesia – more commonly known as ‘pins and needles’ – is normally felt as a tingling or pricking sensation in the fingers and toes. The main cause of paraesthesia is pressure on the peripheral nerves or damage to those nerves.

Paraesthesia can also manifest as a burning, creeping or crawling sensation or even an itchy feeling. These abnormal sensations usually arise in the hands and feet but may be more widespread. Some people experience paraesthesia in the arms or legs, or even in the back and neck.

In most cases, paraesthesia itself is not painful. It may, however, be accompanied by pain related to damage to nerves and other tissues.


Most cases of pins and needles are temporary and are caused by putting sustained pressure on a nerve or nerves. This is commonly related to sleeping or sitting in a particular position for a long period of time. Changing posture to relieve the pressure will typically resolve paraesthesia quite quickly.

Where paraesthesia persists it may be a symptoms of an underlying nerve problem. This can be a neurological disease like multiple sclerosis or transverse myelitis, or the result of a stroke or transient ischemic attack (TIA). Tumors or lesions in the brain or spinal cord are rarely the cause of paraesthesia but can be ruled out through medical imaging.

Carpal tunnel syndrome is a potential cause of paraesthesia as this condition can damage peripheral nerves in the arm and hand. Cardiovascular problems can also contribute to paraesthesia, making the condition more common in older people. This is because peripheral vascular disease can reduce the supply of blood and nutrients to nerves.

Inflammatory disease can also lead to paraesthesia by putting increased pressure on the nerves. As such, the symptom is more common in some people with rheumatoid arthritis and psoriatic arthritis. In some cases, muscle cramps and whiplash can be the cause of pins and needles.


Paraesthesia accompanied by progressive weakness or pain in the hands, feet, arms, or legs, suggests significant ongoing nerve or spinal cord damage. This requires immediate medical attention, as does regular or persistent paraesthesia.

For the most part, however, paraesthesia is nothing to worry about. It can typically be resolved and avoided by maintaining a healthy posture, both while awake and when sleeping.


Disc degeneration, osteophyte growth, spinal slippage, and other cause of back and neck pain can also also cause paraesthesia. Pins and needles can also occur in people recovering from spinal surgery and may in fact be a good sign! For patients with nerve damage from a spinal problem, restored sensation (even abnormal sensation like pins and needles) can indicate that the nerve is not permanently damaged and may recover full function.

So, next time you experience pins and needles, think about how you were sitting, sleeping or standing and consider modifying your posture to avoid putting pressure on your nerves. If paraesthesia persists or occurs regularly, or is accompanied by pain, contact your health care worker.

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