Paresthesia is defined as the abnormal feeling of burning, tingling, or numbness without any stimuli present. Some people describe it as a prickling feeling or itchy skin.
Some say it’s a crawling sensation. While others describe it is a coldness. These different sensations commonly occur in the extremities, hands, feet, arm, and legs, but it can occur anywhere in the body.
What Causes Paresthesia?
It’s thought that the body misinterprets stimuli and that cause these unusual sensations. This can happen in either the peripheral nervous system or the central nervous system.
The most common reasons why this disorder occurs in the peripheral nervous system include; trauma, an imbalance in the body chemicals, genetics, inflammation, toxins, nutritional deficiencies, B12 deficiencies, malignant growths, and neuropathy.
When a burning pain known as causalgia occurs in the peripheral nervous system, it’s generally caused by a pinched nerve. The nerves most commonly pressed against are; the ulnar nerve, tarsal nerve, posterior tibia and lateral femoral nerve.
Diseases like hypothyroidism, carpal tunnel, diabetes, radiculopathies, and alcoholism can also cause paresthesia.
Exposure to harmful toxins in the workplace may cause this syndrome as well. Some of the toxins include; mercury, lead, arsenic, carbon disulfide. Chemotherapy and other medicines can create this painful feeling.
The reason why this might occur in the central nervous system include; diseases, degeneration, ischemia, infection, and inflammation,
Small cancerous cells in the breasts ovaries, lungs and stomach can cause this type of problem.
Malignancy and reflex sympathetic dystrophy might cause this condition to occur, but it’s very unlikely. Reflex sympathetic dystrophy occurs when there in injury to the soft tissue at the far end of your arms and legs.
How to Diagnose
The doctor will first get a medical history on you. This should include any past or present illnesses and medicines you are taking. He will ask you about when and how this began, how long it lasts and where this sensation is located.
The doctor will ask if you’re experiencing any other symptoms besides the pain. He will ask you about your activities, if you use street drugs, have you had any past or recent accidents.
Could you have been exposed to any toxic substances? Lastly, the doctor will question you about past and present jobs.
He will then ask about family history. This should include diseases like diabetes, thyroid, neuropathy, and malignancy.
He will do a series of lab tests and possibly some type of imagery. He will order a CBC complete blood count, A Chem 7 chemistry profile. He will check for levels of B12, VDRL, and B12. He might check for toxins in the blood.
The doctor will want a urinalysis, to check for hormone levels and sediment rate.
He will then on a physical exam. He will test fine motor skills and sensory perception, how your body responds to different stimuli in varying nerve locations.
The doctor will use sharp and soft objects for this. He will begin where there are no symptoms and work towards problem areas. This is called sensory mapping and it will tell the doctor the problem location and the extent of the condition.
He will look for color and temperature of the skin, and nerve changes in the extremities, He will also check for muscle atrophy, wasting away of the muscles.
The doctor will then use a 128 cps tuning fork to see how your body responds to the sensation. This tool is placed on different boney areas on the body starting with the furthest away from the problem area as possible. The doctor will slowly work towards the painful area.
This test could help the doctor rule out peripheral neuropathy. It’s often found in alcoholism, dorsal column disease, diabetes and B12 deficiencies.
He will order aCT scan and X-ray. They will help him determine if there are any abnormalities that might be causing this to occur. He will specifically look at the brain and spinal cord. Some of the possible abnormalities might include disk degeneration, herniated disk, and spinal cord injuries.
He will probably want to do a chest X-ray, to check for abnormal tumors and TB.
He might order an EEG and MRI. The EEG will help him determine how well your nerves are sending and receiving signals. Where an MRI will rule out abnormal blood vessels and lesions.
He also might want to do a lumbar puncture to check for things like meningitis, syphilis, and inflammation.
Occasional the doctor will want to biopsy the nerve. This could rule out the possibilities of sarcoidosis, polyarteritis nodosa, and amyloidosis.
Another test, the doctor might do is proprioception. The doctor will ask you to close your eyes, he will then grab a finger, or toe and move it. He will then ask if he moved it up or down. This test is to rule out things like dorsal-column disease, abnormalities of the peripheral nerve and lesions on the nerve root.
The doctor might fill test tubes up with water at varying temperatures. He will then ask you about the different temperatures. This is called a thermal sensation test.
Once all the test results are back, the doctor will take the findings, compare and connect them with other abnormalities that he’s found.
This will help him determine if there are problems at the nerve root, or if your pain is caused by a specific disease like hyperreflexia, myelopathy, neuropathy or other nerve disorders.
Sum It Up
Paresthesia is a disorder where a person feels tingling, numbness, burning, or coldness their extremities without any stimuli being present.
This disorder can occur in either the peripheral or the central nervous system for varying reasons. Some of them include; infection, disease, chemical imbalance, pinched nerve, toxins, medicines, nutritional deficiencies. Malignant growth neuropathy and genetics.
The doctor will do a variation of a lab test, imagery, and nerve impulse test to determine the cause. The treatment for this disorder would depend on the underlying cause.