The paresthesia it is a medical condition characterized by burning sensations, numbness, tingling, itching or stinging, which is usually felt in the upper extremities (arms and hands) and lower extremities (legs and feet).
It usually occurs in a hand or foot and does not usually cause pain. Patients frequently report sensations of numbness, tingling and numbness in the hands, legs, arms, face, feet or other parts of the body in clinical consultations.
This type of sensation can appear temporarily or permanently. In most cases, it is a temporary pathology that is usually caused by the existence of pressure on one of the nerves.
However, it can also be a symptom of acquired injury or a wide variety of diseases or disorders that cause damage to the nervous system..
These sensitive symptoms, especially in the upper extremities, are usually a frequent reason for consultation in primary care services. In most cases, it is due to the development of a degenerative pathology or neuropathies due to nerve entrapment.
Due to the fact that they are mild and not very explicit symptoms, in many cases an incomplete evaluation tends to be carried out, underestimating some of the symptoms that can be warning signs of other more severe pathologies.
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At different times, many of us, after sitting cross-legged for a while or if we lean on one arm for a long time, feel a tingling sensation or say that a foot or arm “falls asleep”. We experience paresthesia, that is, a sensation of pricks, numbness or burning, by the foot or by the arm, discomfort without generating pain.
The stimulation and sensations of the different parts of our body are carried by the peripheral nerves to the spinal cord. From the spinal nerves, the signals are conducted to the brain through the brain stem. In this way, some interruption in this signaling pathway may result in the development of paresthesia..
Therefore, this type of annoying sensations are produced as a result of pressure on certain nerves..
In addition, they can occur as a result of different conditions, diseases or disorders that are going to cause nerve damage. Some of the causes can be: brain tumor, stroke, anemia, encephalitis, diabetes, multiple sclerosis, peripheral neuropathy, among others.
People with paresthesia often describe their symptoms and signs using multiple terms. Among them we can highlight: burning, numbness, itching and tingling.
Many patients refer to symptoms as:
Symptoms tend to occur more frequently in the arms, legs, hands, and feet, however they can also occur in other parts of the body.
Paresthesia is usually a symptom of other neurological diseases, conditions, or disorders, so paresthesia can also lead to some of the following symptoms:
Despite this symptomatic description, these will vary depending on the nerves that are involved and the severity of the alteration. For example, pressure on the ulnar nerve can cause paresthesia in the little finger and various areas of the hand..
Normally, paresthesia occurs temporarily due to some activity or position that exerts prolonged pressure on one or more nerves..
It is common to appear when crossing the legs, when sitting for a long time, sleeping on one of the upper extremities, etc. Therefore, the uncomfortable sensations usually disappear when the pressure is relieved..
However, it can also present in a more severe and even permanent / chronic form due to orthopedic disorders or neurological conditions that cause permanent damage to the nervous system. In addition, in more than one case, paresthesia is a primary manifestation of some type of serious pathology..
The temporary condition will cause tingling and / or numbness that goes away quickly. Some of the causes are described below:
When symptoms of paresthesia start to appear on a regular or intermittent basis it could be indicative of a more serious problem. Generally, it is a sign of a neurological disease or traumatic damage.
In general, it is frequent that it appears due to an infection, inflammation, trauma or abnormal process that affects the nerves. It is less frequent that it appears associated with disorders that endanger the life of the individual, however, it can occur due to the suffering of cerebrovascular disorders and / or tumors.
The main causes of prolonged or chronic paresthesia are:
Paresthesia is frequently associated with alterations in both the central and peripheral nervous systems..
In the central nervous system they can be caused by: stroke, intracerebral hemorrhages, lacunar infarcts, brain tumors, head trauma, encephalitis / meinguitis, abscesses, lumbar stenosis, systemic lupus erythematosus, multiple sclerosis, transverse myelitis, lumbar puncture, vitamin b12 deficiency, etc.
In the peripheral nervous system they can be caused by: peripheral neuropathy, neuropathy due to treatment, carpal tunnel syndrome, lateral femoral cutaneous syndrome, femoral neuropathy, tarsal tunnel syndrome, sciatica, herniated disc, cervical spondylosis, pressure paralysis, Charcot's disorder. Marie-Tooth, amyloid neuropathy, neuralgia, etc..
Insufficient blood supply can lead to both temporary and permanent paresthesia. Among them they can be due to arterial, venous or neurogenic syndromes.
Among them we can find diabetes, alcoholism, hypoglycemia, hypothyroidism, hypoparathyroidism, menopause, abnormal levels of calcium / potassium / sodium, uremia, amyloidosis, etc..
Herpes simplex virus, herpes zosterm virus, canker sores, Lyme disorder, human immunodeficiency virus, leprosy, syphilis, Guillain-Barré syndrome, rabies, etc..
Rheumatoid arthritis, lupus, Sjogren's syndrome, anemia, diabetes, arthritis, fibriomyalgia, nutritional deficiency.
B12, b1, b5, b6.
Alcoholism, tobacco use, drugs of abuse, heavy metals, nitrous oxide, carbon monoxide, etc..
Transient processes usually disappear when the pressure is reverted, however, the treatment of chronic processes implies the treatment of etiological pathologies, which will therefore be different for each one of them..
Furthermore, paresthesia in turn can cause different complications in the underlying disease or disorder. Many people with paresthesia may show difficulties in marking, ambulation, or difficulty with grasping..
Due to the fact that it is a pathology that affects the nervous system, there is a risk of suffering from chronic pain, disability, difficulty in breathing, paralysis and therefore, a poor quality of life.
On the other hand, when sensitivity is significantly affected, some individuals may be unable to perceive some injuries such as a wound or burn, putting their lives at risk in some cases..
In addition, numbness in the legs and feet, and especially the loss of sensation, can greatly increase the risk of falls..
Therapeutic intervention will focus primarily on identifying the condition that causes paresthesia. The use of the clinical history, physical examination and different laboratory tests will be essential for its determination..
In addition, it will also be important to determine if it is a transient or chronic process due to the implications that the latter may have for the integrity of the individual's nervous system..
Some of the questions to be answered are:
- Where do you notice the numbing or uncomfortable sensations??
- At what point did you begin to perceive them?
- How long do you feel them?
- Do you carry out any type of activity that causes it?
The choice of treatment for this condition will largely depend on the cause that is causing it..
If the paresthesia is transient, the use of measures that try to restore circulation through exercise, massage, or stretching of the affected limb will be useful. These actions will make the tingling and numbness sensation gradually disappear..
In the case of the prolonged presence of paresthesia, when it is due to secondary pathological causes, the treatment will be oriented to the treatment of the etiological diseases and the relief of the symptoms. Some professionals recommend the use of anti-inflammatory drugs such as ibuprofen or aspirin under a medical prescription when symptoms are mild..
Apart from these, non-pharmacological interventions are being developed that include nutritional regulation, exercise, avoiding the consumption of alcohol or tobacco, which can help the patient to control the discomfort derived from their symptoms.
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