Numbness

Numbness in the feet, legs, and or hands can be debilitating. Loss of proprioception, the ability to know where your extremities are in time and space can lead to falls, muscle fatigue, blood flow issues, and undetected cuts that can become infected and lead to amputations and MRSA. Numbness and Neuropathy is much more dangerous than previously thought.

The common name for numbness is Peripheral Neuropathy. This neuropathy can be caused by many things such as diabetes, chemotherapy treatment for cancer, exposure to toxic chemicals, and cardiovascular problems.

Even some common prescription drugs used to treat the pain of neuropathy can cause numbness, Lyrica, Cymbalta, Neurontin are among those that can cause or exacerbate numbness. Some unrelated drugs that treat high blood pressure can cause numbness by taking too high a dose resulting in lowering the blood press so much that blood flow to the feet or hands is impaired.

Fortunately, emerging medical technologies have focused on electrical stimulation of the peripheral nerves, and this particular form of stimulation has completely resolved numbness 88% of the time. What researchers have found is that by copying the exact waveform of a healthy peripheral nerve and re-injecting it into the nervous system, it seems to" re-boot" the nerves and the peripheral nerves begin to function properly again. This stimulation is painless and can be administered at home. Best of all it does not require any prescription.

We have reviewed and evaluated the various commercialized electrical stimulation systems and recommend the ReBuilder. More information is available on their website: http://www.rebuildermedical.com/numbness.

Illustration patient being treated with the ReBuilder

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Alternative Names

Sensory loss; Paresthesias; Tingling and numbness; Loss of sensation

Definition

Numbness and tingling are abnormal sensations that can occur anywhere in your body, but are often felt in your fingers, hands, feet, arms, or legs.

Causes

There are many possible causes:

  • Remaining in the same seated or standing position for a long time
  • Injury to a nerve -- for example, a neck injury may cause you to feel numbness anywhere along your arm or hand, while a low back injury can cause numbness or tingling down the back of your leg
  • Pressure on the spinal nerves, such as from a herniated disk
  • Lack of blood supply to an area -- for example, plaque buildup from atherosclerosis in the legs can cause pain, numbness, and tingling while walking (this is called vascular claudication)
  • Other medical conditions, including:
  • Abnormal levels of calcium, potassium, or sodium in your body
  • A lack of vitamin B12 or other vitamin
  • Certain medications
  • Toxic action on nerves, such as that from lead, alcohol, or tobacco
  • Radiation therapy

Home Care

The underlying cause of numbness or tingling should be identified and then treated by your doctor. Treatment of the underlying condition may reverse the symptoms or prevent them from becoming worse. For example, if you have carpal tunnel syndrome or low back pain, certain exercises may be recommended.

If you have diabetes, your doctor will discuss ways to control your blood sugars.

Medications that cause numbness or tingling may need to be switched or adjusted. DO NOT make any changes to your medications without instructions from your doctor.

Low levels of vitamins will be treated with vitamin supplements.

Because of the decrease in feeling, a numb hand or foot from any cause may be more prone to accidental injury. Take care to protect the area from cuts, bumps, bruises, burns, or other injury.

When to Contact a Medical Professional

Go to a hospital or call 911 if:

  • Weakness or paralysis occurs with numbness or tingling
  • Numbness or tingling occur just after a head, neck, or back injury
  • You cannot control the movement of an arm or a leg or you have lost bladder or bowel control
  • You are confused or have lost consciousness, even briefly
  • You have slurred speech, change in vision, difficulty walking, or weakness

Call your doctor if:

  • Numbness or tingling has no obvious cause (like a hand or foot "falling asleep").
  • You have pain in your neck, forearm, or fingers.
  • You are urinating more often
  • Numbness or tingling is in your legs and worsens when you walk
  • You have a rash
  • You have dizziness, muscle spasm, or other unusual symptoms

What to Expect at Your Office Visit

Your health care provider will take a medical history and perform a physical examination, with careful evaluation of your nervous system.

Medical history questions may include the following:

  • What part or parts of your body have numbness or tingling? The trunk? Your legs or feet? Your arms, hands, or fingers?
  • Which side of your body is involved?
  • Which aspect of the specific body part? For example, is your inner thigh, calf, or foot affected? Your palm, fingers, thumb, wrist, or forearm?
  • Does the numbness or tingling affect your face? Around your eyes? Your cheeks? Around your mouth? Is one or both sides of your face involved?
  • Does the part of your body with numbness or tingling change colors? Does it feel cold or warm?
  • Do you have other abnormal sensations?
  • Do you ignore everything on the affected side?
  • How long have you had the numbness or tingling?
  • When did it start?
  • Does anything make it worse like exercise or standing for long periods of time?
  • Do you have any other symptoms?

Your doctor may also ask you questions to determine your risk for stroke, thyroid disease, or diabetes, as well as questions about your work habits and medications.

Tests may include:

References   

American Diabetes Association (ADA). Standards of medical care in diabetes. VI. Prevention and management of diabetes complications. Diabetes Care. 2007 Jan;30(Suppl 1):S15-24.

Creager MA, Libby P. Peripheral arterial disease. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Saunders; 2007:chap 57.

D'Cruz DP, Khamashta MA, Hughes GR. Systemic lupus erythematosus. Lancet. 2007 Feb 17;369(9561):587-96.

Piazzini DB, Aprile I, Ferrara PE, et al. A systematic review of conservative treatment of carpal tunnel syndrome. Clin Rehabil. 2007;21(4):299-314.

Transient

Paresthesias of the hands and feet are common, transient symptoms of the related conditions of hyperventilation syndrome, often open mouth, and panic attacks.

Other common examples occur when sustained pressure has been applied over a nerve, inhibiting/stimulating function, or an artery[1], inhibiting blood flow, in which case, removing the pressure will typically result in gradual relief of these paresthesias, often described as a "pins and needles" feeling, especially in the case of reduced arterial blood flow.

 

Chronic

Chronic paresthesia indicates a problem with the functioning of neurons.

In older individuals, paresthesia is often the result of poor circulation in the limbs (such as in peripheral vascular disease), also referred to by physicians as PVD or PAD), most often caused by atherosclerosis, the build up of plaque within artery walls, over decades, with eventual plaque ruptures, internal clots over the ruptures and subsequent clot healing but leaving behind narrowing of the artery openings or closure, both locally and in downstream smaller branches. Without a proper supply of blood and nutrients, nerve cells can no longer adequately send signals to the brain. Because of this, paresthesia can also be a symptom of vitamin deficiency and malnutrition, as well as metabolic disorders like diabetes, hypothyroidism, and hypoparathyroidism.

Irritation to the nerve can also come from inflammation to the surrounding tissue. Joint conditions such as rheumatoid arthritis and carpal tunnel syndrome are common sources of paresthesia. Nerves below the head may be compressed where chronic neck and spine problems exist and can be caused by, amongst other things, muscle cramps which may be a result of clinical anxiety or excessive mental stress, bone disease, bad posture, unsafe heavy lifting practices or physical trauma such as whiplash. Paresthesia can also be caused simply by blocking of the blood stream to a limb by applying weight [or pressure] on to the limb for extended periods of time. Another cause of paresthesia, however, may be direct damage to the nerves themselves, i.e. neuropathy, which itself can stem from injury or infection such as Lyme disease, or which may be indicative of a current neurological disorder. Chronic paresthesia can sometimes be symptomatic of serious conditions, such as a transient ischemic attack, motor neurone disease, or autoimmune disorders like multiple sclerosis or lupus erythematosus. The herpes zoster virus can attack nerves causing numbness instead of pain commonly associated with shingles. A diagnostic evaluation by a doctor is necessary to rule these out. Demyelination diseases may also cause cross-talk between adjacent axons and lead to parasthesia. During impulse conduction some aberrant current that escaped a demyelinated axon can circulate in the exterior and depolarize an adjacent demyelinated, hyperexcitable axon. This can generate impulses conducted in both directions along this axon since no part of the axon is in a refractory state. This becomes very serious in conditions such as Multiple Sclerosis and Guillain-Barre Syndrome.

 

Other known causes

Treatment

Treatment should be decided by a neurologist. The nerve conduction study usually provides useful information for making diagnosis. A CT scan is sometimes used to rule out some causes from the central nervous system.

Medications offered can include the immunosuppressant prednisone, intravenous gamma globulin (IVIG), anticonvulsants such as gabapentin or gabitril and antiviral medication, amongst others, according to the underlying cause.

In some cases, rocking the head from side to side will painlessly remove the "pins and needles" sensation in less than a minute. A tingly hand or arm is often the result of compression in the bundle of nerves in the neck. Loosening the neck muscles releases the pressure. Compressed nerves lower in the body govern the feet, and standing up and walking around will typically relieve the sensation. An arm that has "fallen asleep" may also be "awoken" more quickly by clenching and unclenching the fist several times; the muscle movement increases blood flow and helps the limb return to normal.

Manipulation of the neck won't apply to facial paresthesia, such as early stages of Bell's palsy, as nerves of the face and scalp don't pass through the neck.

Paresthesia caused by shingles is treated with appropriate antiviral medication.

 

Acroparesthesia

Acroparesthesia is severe pain in the extremities, and may be caused by Fabry disease, a type of sphingolipidosis. [3]

 

References

  1. ^ http://www.ninds.nih.gov/disorders/paresthesia/paresthesia.htm
  2. ^ Nitrous Oxide
  3. ^ Marks, Dawn B.; Swanson, Todd; Sandra I Kim; Marc Glucksman (2007). Biochemistry and molecular biology. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. ISBN 0-7817-8624-X. 

 

External links

Symptom: Numbness



TopIntroduction: Numbness

Further information about Numbness is below, or review more specific information about these types of Numbness: arm numbness, hand numbness, finger numbness, leg numbness, foot numbness, toe numbness, numb thigh, facial numbness or other types.

Numbness usually arises from damage or disease of nerves. Numbness is often associated with or preceded by abnormal pain-like sensations often described as pins-and-needles, prickling or burning sensations; these are called paresthesias. Numbness is loss of sensation whereas paralysis usually involves both the loss of the ability to move the area and loss of sensations. The term "numbness" is also sometimes used to refer to emotional numbness or detachment. Any numbness or abnormal sensation symptoms need prompt professional medical advice.

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TopCauses of Numbness:

The following medical conditions are some of the possible causes of Numbness. There are likely to be other possible causes, so ask your doctor about your symptoms.

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TopCauses of Types of Numbness:

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TopNumbness: Multiple Symptom Checker

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TopHome Diagnostic Testing and Numbness

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TopDiagnostic Guides for Numbness

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Medical Books Excerpts
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