Paresthesia: what is it, main symptoms, causes, treatment methods, folk remedies

Paresthesia is numbness of the limbs or other areas, which is accompanied by subjective symptoms such as burning or tingling. In many cases, the disease is curable - medications and physiotherapeutic procedures are used for therapy. If necessary, surgery may be prescribed.

Paresthesia: what is it?

This term refers to a sensitivity disorder in which a person feels a burning, tingling or “crawling” sensation. These are subjective sensations associated with objective reasons. As a rule, they are associated with irritation of a nerve that lies close to the surface of the skin. This may be the result of a shock, mechanical pressure, or due to a temporary interruption of the blood supply.

The main factors leading to paresthesia:

• prolonged compression, for example, of a limb;
• osteochondrosis of any part of the spine;
• tumors of different nature (benign, oncological);
• tourniquets that are applied to stop bleeding;
• nerve ending injuries;
• burns, exposure to high temperature (this may cause problems with the sensitivity of the tongue and lips);
• inflammation in the vascular tissues that supply nerve cells with blood;
• diabetes mellitus and other hormonal disorders;
• poisoning with chemical poisons, biological toxic substances;
• deficiency of certain B vitamins;
• Iron-deficiency anemia;
• intermittent claudication;
• atherosclerosis;
• incorrect position at night (during sleep);
• mechanical shocks.

Numbness of the limbs

15688 August 21

IMPORTANT!

The information in this section cannot be used for self-diagnosis and self-treatment.
In case of pain or other exacerbation of the disease, diagnostic tests should be prescribed only by the attending physician. To make a diagnosis and properly prescribe treatment, you should contact your doctor. Numbness, or paresthesia, is a disorder of the sensitivity of body tissues that occurs due to damage to the peripheral nervous system.

It can be accompanied by various sensations: from tingling, goosebumps to a general decrease in sensitivity of any part of the body, most often the limbs.

The patient feels any tactile influence as if through a layer of cotton wool.

Varieties

Depending on the duration and location, several types of paresthesia are distinguished. Temporary or transient paresthesia may be due to decreased blood flow (ischemic). This type of numbness occurs when there is spasm or compression of the vessels of the limb. Permanent paresthesia is also possible when nerve fibers are crossed or compressed during surgery, trauma, cancer and degenerative changes in the musculoskeletal system.

Reasons for appearance

An example of transient paresthesia is sensory disturbance during a hypertensive crisis.

. This condition is characterized by a sudden increase in blood pressure and is accompanied by symptoms such as severe headache, dizziness, nausea, vomiting, visual disturbances, spots before the eyes, and paresthesia of the extremities.

It should be noted that the clinical symptoms of a crisis can be observed even at low pressure values; the main role is played by the suddenness and difference in the difference between systolic and diastolic pressure.
Raynaud's syndrome
is an episodic disturbance of blood circulation in the extremities due to a sharp spasm of peripheral vessels in response to cold exposure or emotional stress, which quite often causes loss of sensitivity. Most often, the fingers are affected, which from exposure to cold become almost white or bluish-violet and lose sensitivity. After the spasm stops (usually after 15-20 minutes), blood flow in the extremities is restored, as evidenced by the normalization of skin color and sensitivity.

Tunnel or compression syndromes

are among the most common causes of numbness of the extremities. Compression (compression) of the nerve fiber, located in the narrow space between the bone and muscles of the limb, occurs due to swelling that occurs with injuries to the joints and ligaments.

The first symptoms of this condition are pain, sometimes a sensation of current passing (electrical shooting), numbness, weakness and dysfunction, which subsequently lead to muscle atrophy and loss of motor ability of the limb.

Compression of the nerve roots (
radiculopathy
) due to herniated intervertebral discs and tumors is also accompanied by numbness of the limb. Depending on what level of the spine the nerve is pinched, pain and numbness in certain parts of the limb, impaired reflexes, muscle weakness, stiffness in the spine, and pain in the projection of the affected root when coughing or sneezing may occur.

With radiculopathies, pain increases in an upright position of the body and decreases in a lying position.

Polyneuropathies
can cause numbness in the extremities . A sign of polyneuropathy is symmetrical damage to the limbs. Multiple damage to peripheral nerves occurs due to decreased nutrition of nerve fibers (metabolic polyneuropathy). A typical example of peripheral nerve damage is diabetic polyneuropathy. It is characterized by slow progression and gradual development of motor and sensory disorders. Alcoholic polyneuropathy develops much faster.

Its characteristic symptoms include numbness and loss of sensation in the lower extremities, starting with the feet, and soreness of the calf muscles. Later, these symptoms are accompanied by weakness and paresis (decreased muscle strength) of the limbs.

Paresthesia can occur with drug-induced polyneuropathy when taking certain drugs, with uremic polyneuropathy in patients with chronic renal failure, as well as with other diseases.
Paresthesia, a feeling of numbness and pins and needles are the main signs of B vitamin deficiency
. In particular, with a lack of thiamine (B1), polyneuropathy develops, which is manifested by a “pins and needles” sensation.

Cyanocobalamin (B12) deficiency

leads to degenerative changes in the spinal cord, which are accompanied by a feeling of numbness, tingling in the limbs, gait disturbance, memory loss and loss of tendon reflexes.
Similarly, with hypocalcemia
(lack of calcium in the blood), paresthesia and seizures are the leading clinical manifestations of the disease. Calcium deficiency can develop against the background of pancreatitis, sepsis, hormonal disorders (in particular, with hypoparathyroidism), blood loss during major operations and injuries.

Among the demyelinating lesions

diseases that cause numbness in the extremities include multiple sclerosis.

With this disease, demyelination (destruction of the myelin sheath) of nerve fibers occurs in various parts of the central nervous system, which significantly disrupts the conduction of impulses through neurons.

Sensory impairment is one of the earliest and most common symptoms of multiple sclerosis. The patient experiences a transient feeling of numbness, “pins and needles” in various parts of the body, most often in the tips of the toes or hands. This sensitivity disorder is focal in nature.

Loss of sensitivity in the limbs, numbness occurs with polymyalgia rheumatica

. This is an inflammatory disease of the musculoskeletal system that develops after the age of 50. Severe pain in the symmetrical muscles of the shoulders, hips, and neck is combined with an acute inflammatory process. The pain intensifies with movement and does not subside even at night. Muscle stiffness is typical both in the morning and after prolonged immobility. Muscle damage is combined with peripheral arthritis, often on one side, which is accompanied by a slight disturbance of sensitivity and paresthesia.

Occupational hazards, exposure to ultrasound

also lead to sensory and vascular disorders. People who are exposed to vibration for a long time develop increased sensitivity of their hands to cold and periodically experience numbness in their fingers. The skin takes on a cyanotic, marbled color and becomes cold and damp to the touch. Over time, dystrophic changes spread to nerve fibers, muscles, and bones.

Diagnostics and examination

Diagnosis of a disease accompanied by numbness begins with interviewing the patient, which makes it possible to clarify the location and nature of the sensitivity disorder. To exclude the metabolic nature of the disease, blood tests (general clinical and biochemical), determination of the level of glycated hemoglobin, urea in the blood, liver enzymes), calcium levels, vitamin B12 and methylmalonic acid, C-reactive protein and a general urinalysis are necessary.

Types of paresthesia

There are 2 main forms of the disease – transient and chronic. In the first case, tingling, burning and other unpleasant sensations go away on their own, without the use of drugs or surgical intervention. For example, if a person has been in an uncomfortable position for a long time, it is enough to change position, perform an exercise, and the paresthesia will go away without additional treatment.

However, there are also chronic paresthesias. They are associated with damage to different parts of the nervous system. In turn, they are divided into several types:

1. Primary – against the background of infection, for example, HIV, tumor or autoimmune.
2. Secondary - against the background of alcoholism, lack of B vitamins, metabolic disorders, for example, in the case of diabetes.

Rarely, paresthesia manifests itself as numbness of the lips, tongue or chin. Moreover, similar phenomena occur due to dental intervention (removal of wisdom teeth).

Another type is acroparesthesia. These are severe pains in the arms or legs associated with Fabry disease or calcium deficiency, or disturbances in the functioning of peripheral nerves. The main symptoms are tingling, numbness, burning, and numbness in the extremities, especially the fingers.

A view from the point of view of neurology and psychiatry

Dysesthesia is a perversion of susceptibility, characterized by the occurrence of pain in areas of impaired sensitivity, which arise as a response to a slight tactile stimulus or spontaneously.
It can be observed when the central or peripheral nervous system is damaged. Spontaneous or caused for certain reasons (for example, by touch) can be perceived as a pain syndrome (for example, as temperature) and so on:

This concept means perverted disturbances of sensitivity, in other words, the loss of the usual correspondence between an objective stimulus and its biased assessment: when the patient feels an object, it seems larger than its real size.

Sometimes a patient feels an external irritant incorrectly: not in the place or side where it was inflicted, but on the opposite side, let’s say an injection was made in the left thigh, but it is felt in the right.

With tabes dorsalis, there is often a slowdown in the conduction of pain, for example, with a painful injection, the patient does not react to it at all, and after the doctor or someone else, thinking that this is a state of deep anesthesia, moves on to the next steps, new injections with In order to find out its limits, the patient suddenly experiences a feeling of severe pain.

In all of these types of violations, an incorrect assessment of external irritation occurs.

Dysesthesia from a neurological point of view is a disorder (pathology) of sensitivity that occurs as a result of damage to the sensory nerve, pathways, dorsal horns or in the roots of the spinal cord. The penultimate parameter relates only to temperature and pain sensitivity; muscle and joint sensitivity are not affected in this case.

The appearance of dysesthesia from the point of view of psychiatry is similar, but has a different configuration of pathologies of sensitivity and susceptibility. They are caused by a mental abnormality or are symptoms of mental disorders.

Generally speaking, there is no exhaustive and generally accepted classification of disorders of elementary receptivity and sensitivity in modern psychiatry.

Accompanying illnesses

Paresthesia often develops against the background of such pathologies:

• sciatica;
• cervical spondylosis;
• diabetic neuropathy;
• transverse myelitis;
• restless legs syndrome (tingling and burning in the legs).

If complications occur, the disease can progress rapidly. Therefore, patients with these diseases should undergo periodic medical examination.

DIAGNOSIS AND TREATMENT OF NUMBITY

It is very important for the doctor to know what symptoms accompany the loss of sensitivity, what diseases are present, what is the duration, when it intensifies, whether it was preceded by injury or excessive physical activity, and whether there is back pain. All this information allows the doctor to make a preliminary diagnosis. To confirm it, additional diagnostic measures are prescribed. Treatment for numbness will consist of eliminating the identified cause, for example, straightening pinched nerve roots.

Main symptoms

The main symptoms of the disease, regardless of the type, include:

• numbness – weak and strong;
• tingling;
• burning sensation;
• the feeling that goosebumps are crawling all over the body.

Indirect signs are:

• pale skin;
• previously unexperienced hair loss;
• decrease in temperature (only in the affected area).

Often these symptoms occur in the feet, in the neck, especially on the side, on the hands, and in the head area. Normally, such sensations gradually disappear without treatment. But if they are repeated again and again and become pronounced and long-lasting, this clearly indicates the development of the disease. In such cases, you need to consult a doctor for diagnosis and treatment.

Causes and manifestations

Dysesthesia often occurs when the patient is resting and their muscle mass is relaxed. It begins with incomprehensible and inexplicable sensations (tingling, discomfort, “goose bumps”), which gradually intensify. In the morning, the disease very rarely makes itself felt.

Most often it appears after 20 years of life. Every year the intensity of the sensations increases, attacks and exacerbations occur more often. Dysesthesia can be concomitant with symptoms of diseases such as:

• uremia;
• renal failure;
• neurosis;
• rheumatoid arthritis.

It can also occur in pregnant women. It is inherited, but does not pose any serious threats to life.

Characteristic symptoms:

1. Increased sensitivity in nerve endings . Noticed in pathologies in the mucous membranes of the skin.
2. Increased excitability of neurons of the sensory system : hippocampus, sensory areas of the cerebral cortex, nuclei of the amygdala complex, and so on. Occurs with encephalitis, neuroses and certain mental disorders.

Diagnosis of the disease

To determine the disease, the doctor conducts a visual examination, studies the patient’s history and complaints. For example, the condition of the skin, its color and temperature are checked. Laboratory diagnostic procedures are also carried out:

• blood analysis;
• toxicological analysis;
• MRI of the spine, head;
• Ultrasound of cervical vessels;
• X-ray of legs;
• diagnosis of the thyroid gland.

3. Symptoms and diagnosis

Actually, paresthetic sensations are described quite fully at the beginning of the article. In a generalized form, paresthesia can include any sensation in the skin (or under the skin) in which there is no directly observable stimulus in this area. As a rule, paresthesia does not include pain, which is also often accompanied by lesions of the nerve pathways (for example, with herpes zoster).

Paresthesia is diagnosed based on a careful study of the history and sensations verbalized by the patient during a clinical interview and examination (sometimes the condition of the skin in the disturbing area is significant). Skin sensitivity as such must be examined: areas of slightly or insensitive skin are often found. To clarify the nature and localization of the causes of paresthesia, electroneuromyography may be prescribed, as well as, if indicated, tomographic studies of the brain and/or spinal cord; toxicological, virological, biochemical laboratory tests, etc.

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Hyperesthesia (increased tooth sensitivity) - symptoms and treatment

Treatment of hyperesthesia is aimed at reducing the speed of fluid flow in the dentinal tubules. This can be achieved in the following ways:

• blockage of enamel micropores with the help of desensitizers - drugs that reduce tooth sensitivity;
• reducing the size of micropores using mineralizing agents, for example, gels with a high content of fluoride and calcium. These include gels ROCS Medical Minerals, GC Tooth Mousse;
• closing or narrowing of dentinal tubules using a laser [14];
• preparation and filling of teeth for carious lesions;
• surgery on the gum when it recedes as a result of periodontal disease;
• correction of the bite.

In 1935, dentist L. Grossman identified the main properties of an ideal remedy for combating hyperesthesia [12]. In his opinion, it should act quickly and be effective for a long time, not irritate the pulp, not provoke pain and not change the color of the teeth. There are quite a lot of such drugs now. Desensitizing agents (reducing tooth sensitivity) are produced in the form of gel, toothpaste, rinse, varnish, etc. Toothpastes are most often used.

For mild hyperesthesia , as a rule, applications of various solutions are sufficient.

The drug Remodent in the form of a 3% aqueous solution for applications is applied to areas of hyperesthesia for 15-20 minutes. For the course of treatment to be effective, it is necessary to make 8-28 such applications (one 2 times a week) until a positive result is achieved. Sometimes a 3% solution of remodent is used as a rinse (4 times a week). The full course includes about 40 procedures.

Strontium chloride is used in the form of a 25% aqueous solution and 75% paste. When rubbing the paste, stable compounds of strontium appear with the hard tissue of the tooth. This remedy is a good prevention of hyperesthesia after tooth preparation and removal of dental plaque.

To eliminate hyperesthesia, a 30% aqueous solution of zinc chloride is also used. After this, an application is carried out with a 10% solution of potassium ferrocyanide. It seals the tubules with the resulting sediment. The duration of the applications is one minute. The use of a paste containing alkalis is also indicated: sodium bicarbonate, sodium carbonate, potassium, magnesium. It attracts dentinal fluid, which is contained in the micropores of the enamel, and reduces tooth sensitivity.

A modern treatment for hyperesthesia is bifluoride-12, a special colorless varnish containing fluoride, and fluocal, a dental gel containing sodium fluoride. They are carefully applied to the teeth with a brush or foam swab. Both products create a coating that saturates the enamel and dentin with fluoride ions, which leads to a decrease in sensitivity. Fluocal can also be used in the form of an application solution. Typically, a course of treatment with such applications includes only 2-3 procedures. Varnish is usually used as an auxiliary method that enhances the effect of the main drug [15].

Treatment of hyperesthesia with laser has been shown to be the preferred treatment method. It is aimed at narrowing the dentin tubules by combining the proteins of the dentin fluid, partially melting the hard tissues and relaxing the internal nerve receptors. Laser therapy has no side effects [15].

Treatment of generalized hyperesthesia is aimed at eliminating the cause of the disease, so it not only relieves symptoms, but also affects the course of the disease. Treatment must be comprehensive. In addition to treating the main cause of hyperesthesia, it is necessary to restore the mineral composition of enamel and dentin, and normalize the content of phosphorus and calcium in the body. For this purpose, calcium glycerophosphate, clamine or phytolon, as well as multivitamin preparations are prescribed. Taking phosphorus-calcium drugs throughout the course of treatment provides a good prognosis. Otherwise, restoration of normal sensitivity will take a long time.

To eliminate pain at the beginning of treatment, in addition to using toothpaste with phosphate, electrophoresis with a 2.5% solution of calcium glycerophosphate is required. The course of such physiotherapy is 10 sessions. In case of hyperesthesia against the background of impaired neurological status, the use of a galvanic collar according to Shcherbak is indicated (also at least 10 sessions).

Studies have shown that the effect of complex treatment of hyperesthesia occurs quickly and lasts for quite a long time. The content of phosphate and calcium in the dental tissues increases, the level of calcium and phosphate in the blood normalizes.

During the treatment of hyperesthesia of any degree it is necessary:

• select personal hygiene products;
• control bad habits (do not bite nails, pencils);
• adjust your diet (exclude soda, sticky sweets, consume vegetables, fruits and dairy products more often);
• wear a mouth guard at night (for bruxism) [14].

Folk remedies

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Folk remedies will not eliminate the cause of the development of paresthesia, but will help alleviate the symptoms and, thereby, improve the general condition of the person.

First of all, you should carefully monitor your lifestyle and diet. It is recommended to stop smoking and drinking alcohol, and not to abuse hot and spicy foods. Jerusalem artichoke has a good effect (helps eliminate numbness due to its beneficial effect on nerves and blood vessels).

Medicinal baths and contrast baths are also used. To prepare a medicinal bath, you can use herbs such as sage, chamomile, and string. The water temperature should not be hot, but comfortable for humans. Reception time is no more than 15 minutes. You can complement the effect with a massage with warming cream, which is performed immediately after taking a bath.

Contrast baths will help improve blood circulation and increase muscle tone. To carry out the procedure, you should prepare 2 basins with hot and cold water. The essence of the procedure is to alternately lower the feet into one and then into the other basin.

You can purchase a massage roller or brush for daily use. This kind of massage helps improve blood circulation and reduce the symptoms of paresthesia. But you should not massage areas of the body for too long and actively, so as not to injure the skin and cause irritation.

Soothing infusions of medicinal herbs have a good effect, since one of the reasons for the development of paresthesia is psycho-emotional stress. Herbs such as motherwort, mint, chamomile, adonis, and lemon balm are suitable for this. Decoctions are taken during the day in 3-4 doses. The course of herbal treatment lasts no more than 1 month, then a break is taken for several weeks, after which, if necessary, the course is repeated.

The information is for reference only and is not a guide to action. Do not self-medicate. At the first symptoms of the disease, consult a doctor.

Medicines

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Of the B vitamins, preference is given to thiamine (B1) and cyanocobalamin (B12). It is better to use it as intramuscular injections to achieve the required concentration of the vitamin in the blood.

If there is a concomitant disease that increases the risk of developing blood clots, antiplatelet drugs (for example, aspirin) are prescribed. The action of this drug is aimed at preventing the formation of a primary blood clot by inhibiting the process of platelet adhesion. This helps improve blood circulation, as a result, eliminating the feeling of numbness.

Of the antihypoxants, Actovegin has a good effect. This drug consists exclusively of physiological components that are normally present in the human body. The active substance is a deproteinized hemoderivative of calf blood. Every cell in the body needs oxygen, which is used as energy. Actovegin stimulates oxygen consumption by the cell, thus exhibiting its antihypoxic effect.

One of the representatives of antioxidants is vitamin E. It is the main fat-soluble antioxidant that protects fatty acids in and around cells from free radicals and lipid oxidation. Often used in combination with another antioxidant, vitamin C. This vitamin protects muscle and nerve tissue from the effects of free radicals.

Treatment

The attending physician chooses how to treat paresthesia depending on the cause that caused it. For example, therapy for varicose veins involves taking phlebotonics and angioprotectors; The patient may also be recommended to undergo surgical removal of the affected vessels. Normaven® Leg Cream can be used as an additional remedy in the treatment of varicose veins. Clinical studies have shown that using the product for three months can reduce the feeling of heaviness and fatigue in the lower extremities, swelling, cramps, and also reduce the severity of the vascular pattern.

Means for the treatment of leg paresthesias

Symptoms

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The appearance of paresthesia occurs when several electrical impulses of different potential occur in a sensitive nerve fiber. The impulses are layered on top of each other, and, as a result, information from the skin or mucous membrane enters the brain in a distorted form.

The location of symptoms depends on the location of the nerve damage. For example, during a stroke, paresthesia develops on the opposite side of the body (from the area of ​​the brain where the circulatory disorder occurred). Migraine attacks may be accompanied by precursors in the form of paresthesia in the mouth. Polyneuropathy is characterized by localization in the area of ​​the feet and hands.

Symptoms of paresthesia are:

• tingling or burning sensation;
• feeling of "crawling";
• pale skin in the affected area;
• feeling of numbness.

This condition can occur unexpectedly and suddenly, or it can develop gradually with an increase in symptoms. Typically, outbreaks of paresthesia go away over time, then attack again. But there is also a continuous course, for example, in multiple sclerosis with a long history of the disease, when paresthesia is a constant concern.