Alternate Names: Lack of sensation; Sensory loss; Paresthesias; Tingling; Loss of sensation

Considerations: Tingling is an indication of damage or irritation to the nerves in that area. Unlike numbness, tingling suggests the nerve is not completely dead or severed, just injured or experiencing pressure.

Except in cases where the cause is obvious (for example, when a hand or foot "falls asleep" because of the position it is in), numbness and tingling should be discussed with your health care provider.

Common Causes:

• Local injury to the nerves under the skin
• Lack of blood supply to the area
• Pressure on the nerves, caused by a herniated disk, tumors, abscesses or arthritic bones
• Toxic action on nerves (lead, alcohol, tobacco)
• Diabetes and other chemical abnormalities
• Vitamin B-12 deficiency
• Hypothyroidism
• Carpal tunnel syndrome
• Drugs such as chemotherapeutic agents, chloroquine, D-penicillamine, ioniazid, nitrofurantoin, parenteral gold therapy and phenytoin
• Long-term radiation
• Transient ischemic attack (TIA)
• Stroke
• Multiple sclerosis (a less common cause of numbness)
• Seizures
• Migraine

Home Care: The underlying cause should be treated by a health care provider.

A numb hand or foot may be more prone to accidental injury. Take care to protect the area from cuts, bumps, bruises, or other injury.

Call If:

• Tingling or numbness is not explained by an obvious cause (such as position-related "falling asleep" of a hand or foot).
• Numbness and tingling is accompanied by other symptoms.
• Numbness and tingling lasts longer than a few minutes.

What To Expect:

• Location
  • Is it on the main part of the body (trunk)?
  • Is it on the legs or feet?
    • Which leg or foot is it on? Both?
    • Is it on the inner (medial) thigh or calf?
  • Is it on the arms and hands? Which (right, left, both)?
    • Where, specifically is it on the hands or arm? (Palm, fingers, forearm etc.)
    • Is it on the thumb, index, and middle finger only?
  • Is it on the face?
    • Is it around the eye (orbital)?
    • Is it around the mouth (perioral)?
    • Is it on the cheek?
    • Is it on both sides of the face?
  • Is it on the knee?
    • Does it feels like the knee is giving way?
  • Is it in many locations and the location changes (multiple and migratory)?
  • Do you have numbness over the entire hand or foot (like a stocking or glove)?
  • Is it only in the hand or foot (distal extremities)?
• Quality
  • Is it numbness?
  • Is it tingling?
  • Is it another abnormal sensation?
  • Does the affected person ignore everything around them that occurs on the affected side (inattention to environmental stimuli on the affected side)?
  • If two areas of skin on the affected side are stimulated at the same time (pinching, poking gently with a pin or with the finger, or similar stimulus) is there a reflexive response (for example, do they pull away, jerk, or complain of discomfort)?
• Time pattern
  • How long has the numbness lasted?
  • When did it develop?
• Aggravating factors
• Is it worse during or after exercise?
• Is it worse after standing?
• Other
• What other symptoms are also present?

The physical examination will include evaluation of the neurologic system.

Diagnostic tests that may be performed include:

• Blood tests (such as CBC or blood differential)
• Ct scan or MRI of the head or spine
• Electromyography
• Myelography
• X-ray of affected area
• Lumbar puncture
• ultrasound of neck vessels

After seeing your health care provider:
You may want to add a diagnosis related to numbness and tingling to your personal medical record.