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Paresthesia: Causes, Symptoms, Diagnosis And Treatment

Have you ever felt a prickling or tingling sensation in your arms when you go off to sleep at night and slowly, you feel as if the arms are becoming numb? If yes, you might be thinking what could be causing it. This occurs due to a specific underlying problem called paresthesia.

What Is Paresthesia? [1]

Paresthesia is the numbness or prickling sensation that you get in the arms or legs when you fall asleep. This occurs whenyou put pressure on a nerve unknowingly and it usually resolves once you change your position. But, if this numbness persists, you may have an underlying disorder that needs treatment.

What Causes Paresthesia

Carpal tunnel syndrome

It occurs when there is too much pressure on the median nerve in the carpal tunnel, a narrow passageway in the front of your wrist, which is about an inch wide. Repetitive hand motions like typing on a keyboard or piano can cause carpal tunnel syndrome and this causes numbness and pain in the arms and hands [2] .


It is a condition in which the roots of the nerve become compressed, irritated, or inflamed. This causes the arm and hand to weaken [3] .

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Diabetes increases the risk of nerve damage and this happens when your blood sugar level elevates, causing numbness and tingling sensation in the legs and feet.

Cervical spondylosis

It is caused due to the daily wear and tear in the spinal disks in your neck, which can further cause bone spurs and bulging disks. This can lead to narrowing the space of the cervical spine and placing pressure on a nerve root, causing numbness in the arms and hands [4] .

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Sleeping posture

A bad sleeping posture, such as sleeping on your hands or arms also causes numbness in the hands. It is because putting too much pressure on a nerve will block the blood flow causing pain and numbness in the hands [5] .

Vitamin B deficiency

A lack of vitamin B in the body can cause numbness and tingling sensation in the feet, decreased appetite, and muscle weakness. Vitamin B is an essential vitamin needed for the functioning of the brain, central nervous system, and DNA synthesis [6] .

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Thoracic outlet syndrome (TOS)

It is a group of disorders that occurs when the nerves in the lower neck and upper chest area are injured or compressed. This causes numbness in the hand, fingers, and forearm [7] .

Ganglion cyst

They are non-cancerous lumps that grow along the joints in the wrist or hands and if a cyst presses on a nerve, it can cause numbness in the hands [8] .

Symptoms Of Paresthesia

  • Tingling or prickling sensation
  • Burning or aching pain
  • Hot or cold skin
  • Numbness in the affected area
  • Feeling that the affected area has fallen asleep

Risk Factors Of Paresthesia

  • Type 2 diabetes
  • Autoimmune disease
  • A neurological condition, such as multiple sclerosis
  • Vitamin B deficiency
  • Repeated hands movement can compress the nerves
  • Obesity
  • Pregnancy
  • Lying down for a long time

When To See A Doctor

  • Consult a doctor when you have the following problems:
  • Difficulty in seeing
  • Unexplained weakness or pain
  • Difficulty in speaking
  • Numbness or tingling sensation in the face

Diagnosis Of Paresthesia

The doctor will first ask about your medical history and about your activities that involve hand movement. Based on that, the doctor will recommend tests like a CT scan, MRI, blood tests, and X-ray.

Treatment Of Paresthesia [9]

Pain medications

Non-steroidal anti-inflammatory medications, such as aspirin or ibuprofen can help bring relief from pain and inflammation in the hands, legs, and neck.


If the cause of paresthesia is carpal tunnel syndrome, exercises such as stretching, strengthening, and posture exercises can help improve the symptoms and increase the strength of muscle weakness.

Splints or wrist guards

Wearing a wrist guard or splint can keep your wrists straight to reduce the pressure on your median nerve. The wrist guard can be worn when performing repetitive tasks.


If all the above non-surgical treatments don't work, surgery is the next option. Surgery is done to release compressed nerves or blood vessels caused by bulging disks, ganglion cysts, or carpal tunnel syndrome.

View Article References
  1. [1] Nickel Jr, A. A. (1990). A retrospective study of paresthesia of the dental alveolar nerves.Anesthesia progress,37(1), 42.
  2. [2] Caliandro, P., La Torre, G., Aprile, I., Pazzaglia, C., Commodari, I., Tonali, P., & Padua, L. (2006). Distribution of paresthesias in carpal tunnel syndrome reflects the degree of nerve damage at wrist.Clinical neurophysiology,117(1), 228-231.
  3. [3] Henderson, C. M., Hennessy, R. G., Shuey Jr, H. M., & Shackelford, E. G. (1983). Posterior-lateral foraminotomy as an exclusive operative technique for cervical radiculopathy: a review of 846 consecutively operated cases.Neurosurgery,13(5), 504-512.
  4. [4] Mann, K. S., Khosla, V. K., & Gulati, D. R. (1984). Cervical spondylotic myelopathy treated by single-stage multilevel anterior decompression: A prospective study.Journal of neurosurgery,60(1), 81-87.
  5. [5] Roth Bettlach, C. L., Hasak, J. M., Krauss, E. M., Yu, J. L., Skolnick, G. B., Bodway, G. N., ... & Mackinnon, S. E. (2019). Preferences in Sleep Position Correlate With Nighttime Paresthesias in Healthy People Without Carpal Tunnel Syndrome.Hand,14(2), 163-171.
  6. [6] Oh, R., & Brown, D. L. (2003). Vitamin B12 deficiency.American family physician,67(5), 979-986.
  7. [7] Lascelles, R. G., Mohr, P. D., Neary, D., & Bloor, K. (1977). The thoracic outlet syndrome.Brain: a journal of neurology,100(3), 601-612.
  8. [8] Kerrigan, J. J., Bertoni, J. M., & Jaeger, S. H. (1988). Ganglion cysts and carpal tunnel syndrome.The Journal of hand surgery,13(5), 763-765.
  9. [9] Alves, F. R., Coutinho, M. S., & Gonçalves, L. S. (2014). Endodontic-related facial paresthesia: systematic review.J Can Dent Assoc,80(80), e13.
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