Raj N. Sureja, MD
As an Interventional Pain Management Specialist, I frequently see patients who describe a feeling of “pin and needles” in different areas of the body. But what exactly does this unpleasant tingling sensation represent insofar as a diagnosis and subsequent treatment? In this article, I will discuss tingling, why it happens, how I make a diagnosis and how I prescribe treatment.
The sensation of tingling or “pins and needles” immediately lets me know that nerves are involved in some way. Many viruses, conditions or injuries can impact how nerves function, such as herpes (think cold sores), Epstein-Barr virus, diabetes, alcoholism, a bulging or herniated spinal disc, multiple sclerosis, carpal tunnel syndrome, stroke, under-active thyroid, migraines…the list goes on and on. Tingling can be felt basically anywhere in the body there is a nerve and is not necessarily limited to one site with certain conditions. It’s often perceived as worse at night, when we are trying to sleep, because as our mind prepares to rest and it slows its activities, the brain has more bandwidth to focus on any painful stimulus it receives.
When a patient comes to my office complaining of tingling, I’ll review their medical records to see if they have been previously diagnosed with a condition that can cause tingling. I’ll look at any imaging studies to see if a nerve may have been impinged or damaged by a structural abnormality in the skeleton. I’ll also ask the patient many questions about their tingling, where it is in the body, when it’s worse or better, and what they’ve tried to remedy the problem. If a diagnosis already exists and I agree with that diagnosis, I will then proceed with treatment.
If a diagnosis doesn’t exist or is unclear, I may order and MRI or an EMG study to give me more clarity. An MRI will help me see not only bones, but all of the soft tissues surrounding the scanned area. An EMG will help me understand if your nerves are working well to transmit signals to the muscle and the brain in the area that is scanned. I consider myself somewhat of a detective when it comes to making a definitive diagnosis, and the results of these tests may give me the final piece of the puzzle that I need.
Treatment for tingling nerve pain will vary based on the cause. Pain from a nerve that is pinched in the spine may be helped by oral anti-inflammatory medications or an epidural steroid injection, or it may require surgery to permanently resolve the issue. Tingling from diabetic neuropathy may require a medication that helps to calm the nerves and reduce pain, like gabapentin. “Pins and needles” from Carpal Tunnel Syndrome may be relieved with bracing or splinting but may require a nerve release surgery to ultimately fix the problem. Thankfully, I have many therapies with which I can treat tingling. Working together with my patient, we can find the treatment that provides the best relief and gets them back to living life to the fullest.
If you’re interested in making an appointment with Dr. Sureja or another OSC provider, get started online by clicking the “Request Appointment” button below or by calling (757) 596-1900.