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Pins and needles
Category: Brain & Nerves · All brain & nerves symptoms
What it can feel like
Pins and needles is the familiar prickling, tingling or fizzing sensation, most often in the hands and feet. Briefly, after pressure on a nerve ('my foot's asleep'), it is normal and passes in minutes. Tingling that persists, recurs in the same place, or spreads has a mechanism worth finding.
Possible causes
A symptom can have many causes, and most are not serious. The lists below group conditions this symptom can be associated with — common causes first. They are possibilities to discuss with a clinician, not a diagnosis.
Common causes
Pins and needles can be associated with pressure on nerves, carpal tunnel syndrome (night-time hand tingling relieved by shaking), over-breathing during anxiety, and cold hands with Raynaud's colour changes.
Other possible causes
Persistent tingling can be associated with peripheral neuropathy (diabetes, B12 deficiency, alcohol, some medicines), nerve root compression in the neck or back, and, when sudden and one-sided, with TIA or stroke; tingling around the mouth with hand spasms in an unwell person can reflect low calcium.
Red flags — when to seek help promptly
- Sudden tingling or numbness on one side with weakness or speech change — emergency
- Tingling that ascends the legs with increasing weakness
- Tingling with loss of bladder or bowel control, or saddle numbness
- Persistent tingling in the same fingers every night, with weakness or clumsiness developing
What a clinician may do
A clinician will map the distribution, test reflexes, strength and sensation, and arrange blood tests (sugar, B12, calcium, thyroid). Nerve conduction studies characterise trapped nerves and neuropathy; imaging follows when a root or cord problem is suspected.
Related guides on MedicalVideos.com
Frequently asked questions
Why does my hand tingle at night and wake me?
The carpal tunnel — a tight passage at the wrist — swells slightly at night and wrist flexion during sleep raises its pressure, squeezing the median nerve into the thumb, index and middle fingers. Shaking the hand relieves it, which is a classic clue; a wrist splint at night is the first treatment.
Is tingling from anxiety real?
Yes — over-breathing lowers blood carbon dioxide, which changes calcium behaviour around nerves and produces tingling of the hands, feet and around the mouth. It settles as breathing normalises. Tingling that is one-sided, persistent or progressive, however, should never be put down to anxiety without examination.
Related symptoms — Brain & Nerves
Browse the P section of the A–Z list or return to the Symptoms A–Z hub.