Definition

Tingling is a prickling sensation that can occur in any part of the body. Generally, complaints occur in the hands, arms, and feet. Tingling is often found in everyday activities and is generally mild and can recover. However, if tingling persists and no clear cause is found, it may be a symptom of certain diseases or injuries. Treatment for tingling depends on the cause.

Causes

Many things can cause tingling. Everyday activities can sometimes cause tingling, such as sitting or standing in one position for a long time, sitting with crossed legs, or sleeping on your arm. These activities put pressure on the nerves in the hands or feet, causing a tingling sensation. Tingling caused by these activities usually resolves within a few minutes. Once you move, the tingling will gradually subside.

Pressure on the nerves is the most common cause of tingling. Carpal tunnel syndrome (pinched nerve in the wrist), scar tissue, enlarged blood vessels, infections, or tumors can put pressure on the nerves. Similarly, inflammation or swelling of the spinal cord and brain can put pressure on one or more nerves.

Other conditions that can cause tingling include:

• Insect bites
• Vitamin B1, B6, and B12 deficiencies
• Potassium, sodium, and calcium deficiencies
• Radiation therapy or chemotherapy
• Certain injuries like nerve injury in the neck or herniated discs

Skin damage in the form of rashes, inflammation, or injury is another cause of tingling. Conditions that can cause this skin damage include frostbite and herpes zoster (a painful rash caused by the Varicella zoster virus). Some diseases also have tingling symptoms, such as diabetic neuropathy (a complication of diabetes in the nerves), migraines, Raynaud’s Phenomenon, multiple sclerosis, stroke, transient ischemic attack (TIA), seizures, or hypothyroidism.

Diabetes is one of the most common causes of peripheral nerve disorders, accounting for about 30% of cases. One of the symptoms of this peripheral nerve disorder is tingling. In diabetic neuropathy, the initial symptoms are felt in the fingers and soles of the feet and then gradually move up to the upper legs and hands. About two-thirds of diabetic patients experience mild to severe nerve damage. Often, tingling is an early symptom felt by diabetic patients, but it is already too late because nerve complications have occurred.

Risk Factor

Anyone can experience tingling, although the risk increases with age. The risk can also increase in the following conditions:

• Repetitive movements that can press on the nerves, such as typing, playing music, or sports like tennis
• Heavy alcohol consumption
• An unbalanced and nutritious diet, leading to vitamin deficiencies, especially B vitamins
• Suffering from diabetes, especially if blood sugar levels are uncontrolled
• Having autoimmune diseases like lupus or rheumatoid arthritis
• Having nerve diseases like multiple sclerosis
• Experiencing infections such as shingles or those due to the Epstein-Barr virus
• Thyroid gland disorders
• Exposure to toxins
• Family history

For people with diabetes, the following conditions increase the risk of tingling:

• Uncontrolled blood sugar levels increase the risk of nerve damage
• Kidney disease complications. Damaged kidneys will release toxins into the blood that can damage nerves
• Being overweight increases the risk of diabetic neuropathy
• Smoking. Smoking will narrow and harden the walls of blood vessels, disrupting blood flow to the hands and feet, delaying wound healing, and damaging nerves due to a lack of nutrients from the blood

Symptoms

Tingling can affect any part of the body. The most common areas include the hands, arms, legs, soles, and fingers. Tingling may also be accompanied by other nerve symptoms such as numbness, burning sensation, stabbing pain, or even muscle weakness if it affects the motor nerves controlling muscle movement. The affected area will have difficulty performing activities, such as walking.

Tingling accompanied by other symptoms can help indicate the cause of the tingling.

• Tingling with pain and numbness in the hands or feet likely points to diabetic neuropathy
• Tingling and color changes in the fingers or toes point to Raynaud’s syndrome, which is reduced blood flow to certain parts of the body, especially the fingers
• Tingling and pain radiating from the back to the legs point to sciatica, a disorder of the sciatic nerve due to damage or pinching in the lower back
• Tingling spread in several parts of the body may point to multiple sclerosis

Diagnosis

The doctor will ask for your complete medical history. Make sure to report all symptoms you feel, even if they seem unrelated. Also, mention any diseases you have had, history of injuries, infections, or vaccinations in recent times. The doctor also needs to know the medications and supplements you take.

Depending on physical examination findings, the doctor may perform additional tests to make a diagnosis. These tests include blood tests, electrolyte tests, thyroid function tests, toxicology screening, vitamin level tests, and electromyography (muscle electrical activity test). The doctor may also perform a lumbar puncture (examining spinal fluid). Radiology examinations like X-rays, angiography, CT scans, MRI, or ultrasounds on the affected area can also help the doctor find your problem.

Management

Since there are many causes of tingling, your treatment will depend on the cause of the symptoms you feel. Treatment will focus on resolving the medical condition causing it. The success of treatment depends on the accuracy of the diagnosis and the underlying disease therapy.

If you have diabetes, proper blood sugar control will prevent further nerve damage. For patients who experience tingling due to vitamin deficiency, vitamin supplements can help alleviate the tingling problem.

Complications

People with tingling can experience disruptions in their daily activities. If you have tingling complaints, you may also experience decreased sensation in the affected area. You will tend not to feel temperature changes or pain. This can cause you to touch something without realizing it is too hot, which can injure your skin.

Additionally, sharp objects can injure you without you realizing it, especially in the foot area. If you also have diabetes with foot wounds, these wounds can heal more slowly and even spread. Ensure you take preventive measures to protect yourself from burns and other injuries.

Prevention

The following steps can prevent the onset of tingling:

• Avoid repetitive movements or take breaks in between
• If you must sit for a long time, stand and walk briefly every 30-60 minutes
• Do regular relaxation movements like rotating and moving your shoulders, neck, and ankles to keep blood flow smooth
• Expert massage can relax muscle tension and improve blood flow. Some patients report symptom improvement after a massage
• Yoga or meditation can help you relax and not focus on pain or tingling. These exercises also improve body flexibility, preventing fatigue or tingling during activities
• Wear comfortable shoes. Tingling can occur due to tight or uncomfortable shoes
• Use elastic bandages on the wrists to reduce nerve pressure
• If you experience back pain, seek treatment immediately
• Get enough regular sleep. Lack of sleep can make you more sensitive to pain or tingling
• A low-fat, low-salt diet high in vegetables and fruits
• Maintain ideal body weight
• Regular exercise 3-5 times per week, 15-30 minutes per day
• Do not drink alcohol or smoke
• Stress management

When to See a Doctor?

In some cases, tingling or burning can indicate a serious medical condition or injury. Therefore, seek medical attention immediately if you suddenly experience any of the following issues:

• Loss of consciousness, even for a short time
• Confusion or difficulty thinking clearly
• Slurred speech
• Vision problems
• Back, neck, or head injury
• Inability to walk or move
• Feeling weak or severe pain
• Loss of bowel or bladder control
• No clear cause of tingling
• Persistent tingling that disrupts quality of life
• Dizziness, unusual muscle stiffness, or skin rash

Quick diagnosis and appropriate therapy will improve your complaints and prevent further nerve damage.

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