Nerve: Pins & Needles (Parathesia)

Pins and Needles (Paresthesia): Causes, Progression, and Treatment Approaches at PhysioActive

What is Paresthesia (Pins and Needles)?

Paresthesia refers to abnormal sensations such as tingling, prickling, or “pins and needles” that occur when a nerve’s function is temporarily or persistently altered. It can happen anywhere in the body, but it is most commonly felt in the hands, arms, feet, and legs.

Top Causes of your Pins and Needles (Paresthesia)

1. Temporary Compression or Reduced Blood Flow

Sitting or lying awkwardly (“foot falling asleep”).
Tight clothing, prolonged positions, or pressure on a nerve.

2. Nerve Entrapment or Compression

Cervical (neck) or lumbar (low back) disc herniations pressing on spinal nerves.
Thoracic outlet syndrome (TOS) causing nerve and blood vessel compression.
Carpal tunnel syndrome (median nerve compression at the wrist).

3. Peripheral Neuropathy (Nerve Damage)

Diabetes (Diabetic neuropathy).
Vitamin deficiencies (B12 deficiency affects nerve conduction).
Autoimmune conditions (Multiple sclerosis, Guillain-Barré syndrome).

4. Thoracic Spine & Rib Dysfunction

A stiff thoracic spine or rib dysfunction can compress thoracic nerves, causing paresthesia in the chest, arms, or back.

5. Muscle or Fascial Adhesions & Entrapment

Tight muscles (scalenes, pec minor, piriformis) compressing nerves.
Scar tissue from surgery or injury restricting nerve mobility.

What Does It Mean If Paresthesia Progresses to Numbness?

Mild or occasional pins and needles often result from temporary nerve compression (e.g., sitting awkwardly).
Persistent or worsening paresthesia progressing to numbness suggests a more serious nerve conduction problem, such as:
- Nerve entrapment or compression (e.g., herniated disc pressing on a nerve).
- Peripheral neuropathy (e.g., diabetes-related nerve damage).
- Chronic inflammation leading to nerve dysfunction.

Numbness indicates a more significant loss of nerve conduction, meaning the nerve is failing to send signals properly.

Neuropathy: A More Severe Form of Nerve Dysfunction

A neuropathy refers to damage or dysfunction of a nerve or group of nerves, leading to abnormal sensation, weakness, or pain. Neuropathy can be:

Peripheral (affecting limbs) – e.g., diabetic neuropathy.
Entrapment-based (compression or irritation of a nerve) – e.g., carpal tunnel syndrome.
Central (originating from the spinal cord or brain) – e.g., multiple sclerosis or spinal surgery (link to blog)

How Physiotherapy & Osteopathy Help with Your Pins and Needles

Physiotherapy and osteopathy focus on restoring nerve function, relieving mechanical compression, and improving circulation.

✅ Manual Therapy & Joint Mobilization

Cervical & Lumbar Spine Adjustments to relieve nerve root compression.
Thoracic spine & rib mobilization for better nerve glide and function.
Myofascial release to free up restricted nerves.

✅ Neural Gliding & Nerve Flossing Techniques

Helps free up adhesions and improves nerve mobility.
Example: Median nerve glide exercises for carpal tunnel syndrome.

✅ Postural & Ergonomic Training

Corrects forward head posture to reduce cervical nerve compression.
Improves spinal alignment to minimize pressure on nerve pathways.

✅ Strength & Stability Training

Strengthening scapular muscles, core, and deep stabilizers reduces excessive spinal load.
Proprioceptive training to enhance nerve signaling and sensory feedback.

Technology PhysioActive can use to help your pins and needles: Microcurrent, Russian Current, Light Therapy, Laser & Acupuncture

💡 Microcurrent Therapy

Uses low-intensity electrical stimulation to enhance nerve repair.
Reduces pain and nerve hypersensitivity in neuropathy patients.

💡 Russian Stimulation Current

Stronger electrical pulses stimulate weak muscles and improve nerve conduction.
Used in post-injury nerve rehabilitation.

💡 Light Therapy & Laser Therapy

Red light and near-infrared light stimulate nerve healing by enhancing cellular repair.
Improves blood circulation to damaged nerves.
Used in diabetic neuropathy, nerve injuries, and post-surgical healing.

💡 Acupuncture

Stimulates peripheral nerves to reduce inflammation and pain.
Helps reconnect disrupted nerve pathways.
Shown to improve blood flow to compressed nerves.

How Paresthesia is a Conduction Issue vs. a Mechanical Issue

Paresthesia (pins and needles) is a conduction issue—meaning the nerve isn’t transmitting signals correctly.
A mechanical issue (compression, entrapment, or poor movement mechanics) can lead to conduction issues by blocking or irritating the nerve.

💡 Key Takeaway: Nerve conduction problems (pins and needles) can be caused by mechanical issues (postural dysfunction, entrapment, adhesions, spinal misalignment), but they can also result from internal nerve damage or systemic conditions.

At PhysioActive we look at the whole body to determine the primary cause of your parathesia. It is frequently a combination of issue that build up and combine to eventually cause the tingling you are feeling. This can even include the thoracic (and often overlooked) spine.

The thoracic spine & ribs are key regulators of the SNS, influencing nerve health and circulation.
Restricted mobility or dysfunction in these areas can cause paresthesia (pins & needles) in the arms and legs.
Restoring thoracic mobility, rebalancing the ANS, and improving nerve conduction through manual therapy, microcurrent, laser therapy, and neural mobilization can help resolve symptoms.