When referring to paresthesia, we are actually referring to specific neurological symptoms, involving the sensations of burning, prickling, tingling, or numbness of the skin. Another, rarer type of paresthesia is called “formication.” This is a weird sensation that feels like ants or bugs crawling under one’s skin. While paresthesias are usually experienced in the extremities, like in the hands and feet, they can also occur in other parts of the body, like on the back or on the head.
Understanding the difference between the two types of paresthesias can help us determine whether there is an underlying neurological condition involved, or if the condition is a natural response of our body due to our everyday habits. Let’s look at the two different types of paresthesia:
The sensation of “pins and needles” on the skin lasts only for a short period of time, going away without any type of treatment. Durations of 5-10 minutes can be safely defined as “short” periods of time. Given that the usual cause of these symptoms is constant pressure on a nerve, short-term paresthesias are usually caused by prolonged body positions that exert pressure on a specific nerve.
For instance, sitting with your legs crossed for a long period of time exerts a considerable amount of pressure to the peroneal nerve, a nerve responsible for the functioning of the foot from the knee downward. After sitting with legs crossed for a while, everyone has experienced the symptom of paresthesia in one of their feet. This quickly goes away when the legs are uncrossed.
Another common example of transient paresthesia is “lover’s arm,” which is named this because it often occurs as the result of the usual cuddling position couples assume while lying in bed. Laying one’s arm horizontally so another person can sleep on it causes a great deal of pressure on a branch of the median nerve. Waking up and removing the pressure from the nerves relieves the pins and needles symptoms.
In the same way, various other transient paresthesias can be experienced when our bodies are in held in certain positions. They quickly resolve when we change our position, taking pressure off the nerves.
This type of paresthesia refers to the duration of the symptoms and not to their intensity. Chronic paresthesias are experienced over a long period of time, and do not get better or resolve without some kind of treatment.
Just like transient paresthetic attacks, chronic paresthesias are a result of chronic pressure on a nerve, but they are also related to nerve damage or they occur as a complication of a neurological disease.
Some examples of conditions that can cause chronic paresthesia symptoms are:
Other injuries to the central nervous system
Because there are so many different conditions that can lead to paresthesias, there is no specific examination that can be used to diagnose every possible cause. To diagnose the reason paresthesias occur, a physician will:
Take a detailed medical history, including other conditions, neurological symptoms, and diseases in the patient’s family.
Ask about the nature of the pain and other symptoms: location, characteristics, duration.
Carry out examinations like a CT-scan, MRI, blood tests, electromyography, or other diagnostic procedures, depending on the symptoms and possible causes.
Just like the diagnosis, there is not a specific treatment for paresthesias, and the best way to treat the condition will be decided upon after the exact cause has been determined. Examples of possible treatments for paresthesia may include surgery if nerve entrapments or orthopedic problems are causing symptoms, or anti-inflammatory medications to treat pain and inflammation. Corticosteroids, anticoagulants and other medications are also sometimes used by our physicians, depending on the underlying cause of the paresthesias.