Dear Dr Nina: 'Constant pins and needles are starting to worry me'
Q I have noticed pins and needles in my hands and arms when I wake up recently. It is mostly just on the right-hand side, but sometimes it is the left too. It goes away quickly once I move my hands. I feel like it could be positional but should I get it checked out?
Dr Nina replies: Wear and tear in the cervical vertebrae is a very common cause of pain and discomfort in the neck, arm and hands. The vertebrae (bones) in the neck change with age and become worn. This may lead to a narrowing in the space between them or small bony outgrowths which can put pressure on nerves, causing pain anywhere along the arm. The bony change may also cause stiffness of the neck. Pressure on nerves may lead to weakness, pins and needles or numbness in the arms and hands.
Injuries to the shoulder are another possible cause of problems along the arm and into the hand. They may occur due to a sudden injury, wear and tear or due to repeated episodes of strain. Impingement of the nerves leaving the shoulder may lead to pressure, causing pins and needles further along the arm.
The fact that you wake with the numbness in your hand may be down to the way you hold your arm in sleep. Pressure may be placed on a nerve that recovers quickly when you awake. Recovery from any inflammation or injury takes time. The initial goal of treatment is to ensure healing, control pain and swelling, prevent stiffness and regain a very gentle range of motion.
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Carpal tunnel syndrome occurs when inflammation in the wrist leads to pressure on nerves as they pass through a tunnel of connective tissue on their way into the hand. This commonly causes pain radiating from the palm of the hand to the middle three fingers. The pain may be described as tingling or burning, and pins and needles may also occur. This syndrome is more common in pregnancy or any conditions that lead to increased fluid retention. Pain may be eased by wearing a special splint at night.
Vitamin deficiencies may also cause nerve problems. Numbness or pins and needles may be a symptom of B12 deficiency. Others include fatigue, which may be extreme, lack of energy, muscle weakness, mood changes and difficulty with memory and concentration. This deficiency can be picked up on a simple blood test.
A visit to the GP may help identify the cause of the numbness you feel. Physiotherapy is always a good place to start with musculoskeletal pain, muscle weakness or pins and needles. Exercises may help rebalance your joints and improve pain. Treatment such as ultrasound and dry needling does help in some cases but should always be done by a professional trained in this technique.
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