You probably know what it feels like to have a pins-and-needles sensation in your hands or feet after sleeping in an awkward position or keeping your legs crossed for too long. It's annoying, but you shake things out a bit and move on, no harm done. But if you have frequent or long-lasting tingling sensations, it's time to head to the doctor.
"When someone complains of numbness or tingling in the hands and feet, we look at when it started and how it has progressed because that gives us some insight into the causes," explains Stanley Iyadurai, MD, an assistant professor of neuromuscular medicine at Ohio State University. "If we can identify the root cause of the problem, we can treat it or control the symptoms with medicines."
To get to the bottom of this issue—which doctors call neuropathy—you may need blood tests, imaging exams like an MRI or CT scan, or a test called an electromyogram (EMG), which measures the electrical activity in your muscles. In the meantime, here's a look at seven of the most common causes of tingling in the hands and feet.
1. A pinched nerve in your neck or back
Got pain and tingling radiating from your neck to your arms or from your back to your feet? You might have a pinched nerve caused by an injury, poor posture, or an underlying condition like arthritis. Physical therapy or a drug like gabapentin should help, says Iyadurai.
2. A vitamin deficiency
If the tingling is happening in both of your hands (not just one), a lack of vitamin B12 could be to blame. You'd also likely feel tired and lethargic, and you might have anemia. If a blood test confirms this problem, B12 supplements or injections should resolve it.
3. Carpal tunnel syndrome
Too much typing? Been experimenting with power tools? Repetitive motion or vibrations can end up compressing a nerve in your wrist and, in turn, cause tingling in your hands, says Iyadurai. An EMG and ultrasound are typically used to diagnose carpal tunnel syndrome. If you have it, you may need to modify the way you perform daily activities. Other fixes for carpal tunnel include physical therapy, anti-inflammatory drugs, and maybe even surgery.
4. Cervical or spinal stenosis
A narrowing of the spaces in the spinal canal in the neck or spine can put pressure on the spinal cord and/or nerve roots, causing tingling sensations, explains Esther Young, DO, a neurologist at Beaumont Health in Rochester Hills, MI. "Stenosis can be diagnosed with an MRI or CT scan and treated with physical therapy, epidural injections, or surgery, depending on the extent of it."
Whether you have full-blown diabetes or insulin resistance (a common precursor), high blood sugar acts as a toxin to nerves, and can cause tingling in the hands and feet (peripheral neuropathy), explains Iyadurai. If you also have excessive thirst or hunger or you're urinating frequently, ask your doctor about getting a fasting blood sugar test or an A1C test, which checks glucose levels over the previous 3 months. Lifestyle changes and medication can help get your condition under control. (Here are 10 foods that can lower blood sugar naturally.)
An underactive thyroid can cause tingling, as well as fatigue, sensitivity to cold, unexplained weight gain, dry skin, and hair loss, Young notes. It can be easily diagnosed with a blood test; if you have it, you'll need to take synthetic thyroid hormone.
7. Multiple sclerosis
If you have weakness with the numbness or tingling sensations, plus symptoms like double vision, clumsiness, or bladder- or bowel-control problems, multiple sclerosis (MS) could be the culprit, notes Young. An MRI can reveal the telltale plaques or scarring on the brain or spinal cord that occur with MS. Various medications are available to treat symptoms and slow the progression of the disease.