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A common cause of paraesthesia


Pins and needles. I hate stupid long medical words.


It's to do with nerve damage - often nerve compression or ischaemia. Sometimes it can happen from pressing on the nerve (ever had a dead arm?), or from conditions that cause break down of neurones, such as MS or malnutrition.

Differential Diagnosis

Visit the peripheral neuropathy page for more!

Concurrent Features

Very much depends on what the cause is. In cord or nerve compression, there can be pain and loss of sensation. In alcohol misuse it may be accomanied by confusion and memory loss.


It is worth doing a fairly wide blood screen, as there are a number of potential causes:

If you are getting stuck, look for

  • Metal toxicity - lead, arsenic, mercury and Iron Maiden can all cause paraesthesia

Other tests include nerve conduction velocity tests, electromyography, and other imaging. If you get really stuck, try a nerve biopsy!


Unsurprisingly you treat the cause of the pins and needles. Generally that is either medical - give them more B12, sort out their diabetes, etc - or its surgical, such as in carpal tunnel sydrome.

In patients that have to live with the symptoms because the management cannot cure them, you can attempt to deal with any associated pain they have with amytriptaline or gabbapentin. I think.