Malaesthesias (paresthesias) are numbness, tingling, and other sensations that have physical or psychological causes. They are usually triggered by nerve disorders and are easily treatable, depending on their severity.
What are sensations of discomfort?
Malesthesias, or paresthesias, are unusual sensory perceptions such as tingling, burning, or stinging. They feel like pinpricks and are usually triggered by pinched nerves, damage to nerve pathways, or pressure. Paresthesias can occur in all parts of the body. However, the symptoms are predominantly limited to the hands and feet. A well-known form of paresthesia is the “fallen asleep leg“, which most people have experienced at least once. It is caused by an interruption of the blood supply and the resulting lack of oxygen and glucose. Other forms have similar causes.
Causes
Abnormal sensations can have many causes. Commonly, they occur due to pressure on a nerve pathway, hyperventilation, migraine, or myofascial pain. Permanent disorders of the nerve cells, such as neuropathies, also lead to sensory deprivation. These are also chronic and are triggered by metabolic diseases such as so-called hypothyroidism, diabetes mellitus or diabetic neuropathy. Neurological systemic diseases such as multiple sclerosis as well as poisoning by certain drugs, alcohol or heavy metals also trigger permanent paresthesias. So does the overdose of antiepileptic drugs. If only certain areas of the skin are affected, the causes lie in diseases or injuries to certain nerves.
Symptoms, complaints, and signs
Paresthesias are sensory disturbances that are mainly manifested by tingling and numbness. All areas of the body can be affected by these so-called sensory disturbances. However, they occur most frequently in the feet, fingers and hands. Pain is rarely observed in paresthesias. However, in addition to tingling and formication, some sufferers may experience burning or stinging sensations. The stinging then feels like pinpricks. Heat and cold perception disorders may also occur. Overall, paresthesias are characterized by extremely unpleasant sensations, but these do not always have to be limited to specific areas of the body. In severe cases, they can affect the entire body. A distinction is made between two forms of paresthesia. These are a so-called transient (temporary) form and a chronic form. A typical example of a transient paresthesia is a leg or arm that has fallen asleep, which everyone is already familiar with. Here, the oxygen supply to the nerves is usually temporarily reduced due to circulatory disorders. In the chronic forms of paresthesia, however, serious diseases can also be the cause. Since the nerve endings are permanently damaged here, the symptoms persist chronically or may even worsen. A typical example is diabetic neuropathy of the foot, which often develops into a so-called diabetic foot.
Diagnosis and progression
The exact diagnosis can only be made with some effort in the case of paraesthesia. For example, it must be determined in advance on which part of the body the disturbances occur, in what form they occur, and whether they occur permanently or in episodes. As a rule, the diagnosis is followed by an anamnesis by the physician and an X-ray or CT scan. If chronic nerve damage is suspected, the physician checks the reflexes, performs various vibration tests and measures the nerve conduction velocity. If an injury is determined to be the cause during a personal consultation with the patient, the nerve damage is suspected to be permanent. To confirm the suspicion, the impulse transmission of the nerve is measured. In addition, the sensitivity functions are tested. If skin sensation has completely disappeared, a tumor or growth is suspected. In this case, the diagnosis is made by ultrasound examinations. Likewise, tissue samples are taken and evaluated in the laboratory. If the symptoms occur only in the extremities, there may be a circulatory disorder. The physician makes the diagnosis after an ultrasound examination and a detailed discussion with the patient.The course of the paresthesias depends strongly on the respective cause. If the paresthesias are triggered by a tumor, the disease can be fatal, while paraesthesias as a result of circulatory disorders often disappear on their own. If there is permanent nerve damage due to an injury, the symptoms persist but do not necessarily worsen.
Complications
As a rule, paraesthesias always lead to a severe reduction in the patient’s quality of life. Those affected are significantly restricted by them in their daily lives, and paralysis or disturbances in sensitivity occur. It is not uncommon for patients to suffer from a typical tingling sensation when they exert or use the affected region. Due to the disturbances in sensitivity, it may no longer be possible to carry out certain work or everyday activities. Dangers may no longer be assessed correctly, so that dangerous situations may arise in the daily life of the affected person. Complications usually occur when the insensitivity is caused by damage to the nerves and is therefore irreversible. These can usually no longer be treated and there is no positive progression of the disease. Not infrequently, patients are then dependent on the help of other people in their daily lives and can no longer perform many activities of daily living on their own. In the case of a tumor, it may be possible for the disease to progress positively if it cannot be removed in time. However, the further course of the disease depends strongly on the trigger and on the severity of the insensations, so that a general prediction is usually not possible.
When should one go to the doctor?
Perceptual disturbances on the skin should be interpreted as a warning sign from the organism. If they persist, spread over the body or increase in intensity, a doctor should examine and clarify the complaints. In many cases, psychological problems are present that should be treated. At the same time, it must be possible to rule out a physical or organic disorder. If there is over-sensitivity to touch or contact with heat or cold, it is advisable to consult a doctor. If there are circulatory disturbances, irregularities of the heart rhythm or cold limbs, a visit to the doctor is necessary. In case of sleep disturbances, a general feeling of malaise or exhaustion, a doctor is needed. If the person suffers from a tingling sensation on the skin, numbness or legs that have fallen asleep, a doctor should be consulted. If the skin is blue, there is a lack of oxygen in the organism. This must be treated as quickly as possible to prevent a life-threatening condition. If the affected person feels a pressure pain in the region of the discomfort, a pinched nerve may be the cause. A doctor should be consulted before the nerve dies or other permanent impairment occurs. If the insensations lead to poor posture of the body, correction is necessary. If left untreated, the sufferer risks permanent damage to the skeletal system and an increase in discomfort.
Treatment and therapy
Once the cause of the discomfort has been determined, appropriate therapy can be initiated. Again, it is crucial to determine which disorder or disease is causing the effect. If nerve damage is present, the causes are treated first and foremost. The underlying drug or alcohol abuse must therefore be stopped so that the nerves can heal again. If an injury is the cause, physiotherapeutic treatment is initiated. As part of this therapy, an attempt is made to reduce the impairment through gymnastic exercises, massage and other measures. The success depends on the severity of the injury. In the case of a tumor, the treatment is the same as cancer therapy. The insensations have a low priority in this diagnosis and are rarely treated separately. However, the prescribed medication and successful therapy can eliminate the paresthesias. If circulatory disorders are present, the treatment is relatively uncomplicated. Often it is sufficient to prescribe certain medications to balance the vitamin balance. However, in some cases it is also necessary to place a bypass or to treat the blood lipid constrictions surgically. The so-called balloon dilatation is also a proven remedy against insensitivity.
Outlook and prognosis
The prognosis depends on the cause of the sensory disturbances (paresthesias). Last but not least, the individual emotional state determines how a disease is dealt with. Mild forms usually progress without problems and disappear after some time. Treatment is therefore not always indicated. In other cases, therapies help. Nerve entrapments can usually be successfully treated with physiotherapy. For herniated discs, surgery and physiotherapy are available. In principle, such a condition does not reduce life expectancy. In other cases, paraesthesia is permanently present. This is regularly the case after a stroke and with lasting damage to the nerves. Those affected then have no choice but to live with the discomfort. The quality of life suffers. Medication can provide relief, at least temporarily. A disease is not infrequently the consequence of other ailments. The patient’s discomfort is aggravated by the paraesthesia. An exact diagnosis is sometimes difficult. This is especially true if a connection cannot be clearly established. Some patients even have to consult several doctors until an improvement occurs. This fact partly causes unfavorable prospects.
Prevention
Abnormal sensations have innumerable causes, which is why there is no specific prophylaxis. However, it is possible to identify the determining factors and take effective action against them. A healthy diet is just as sensible as regular exercise, frugal alcohol consumption and abstaining from nicotine. In general, it makes sense to pay attention to your body and recognize warning signs early on. People who have suffered an injury to the extremities can avoid paresthesia by consulting a doctor early on. He or she can examine the affected nerve pathways and initiate the appropriate physical therapy if damage has occurred. Last, paresthesia can be prevented by relaxation exercises, regular massage and adequate hydration.
Aftercare
First and foremost, it makes sense to focus on causal aftercare. This means eliminating the causes that promote paresthesia. Thus, in the case of alcohol abuse, it is advisable to begin withdrawal. For diabetics, the focus should be on blood sugar control and medication management. For people with vitamin deficiency, it is advisable to switch to a balanced diet or substitute the deficiency with the help of vitamin supplements. If medications are the cause of paresthesias, they should either be replaced or avoided if possible. Symptomatic follow-up can support and complement causal follow-up in any case. For example, many people who define pain as the leading symptom of paresthesia are helped by combined follow-up in the form of pain medication, relaxation, and stimulation current therapy. Physical measures such as physiotherapy, massages or alternating baths also support positive body perception and well-being on the one hand and increase blood circulation on the other, which has a positive effect on the nerve cells. Symptomatic aftercare can also be used to counteract accidents and injuries. For example, those affected should avoid hot baths without temperature control and hot water bottles to prevent burns. It is also advisable to make foot inspection a daily evening ritual, because blisters or friction ulcerations are often not noticed in paresthesia. If there is gait instability due to the condition, the living environment can be redesigned so that there are fewer opportunities for falling.
Here’s what you can do yourself
The options for self-help for discomfort depend on the cause at hand. Healing of nerve damage caused by a pinched nerve on the body can be aided by massage or balancing movements. The connective tissue or tense muscle areas can be massaged independently by circular movements. In addition, a soothing heat supply is important for support. Controlling posture and avoiding positions in which blood circulation cannot be adequately ensured are helpful. Sporting activities promote blood circulation and stimulate the circulatory system. Controlled fluid intake and the use of alternating baths also support health.If the sensations occur in the fingers and toes, these must be particularly protected when the temperature drops. Warming clothing and targeted movements of hands and feet can be preventive for or eliminate the discomfort. Controlling and optimizing everyday habits remedy problems with sensations in many cases. Targeted body-awareness training sessions help to identify and change unhealthy weight-bearing habits. They are particularly suitable as preventive measures. In cases of numbness or sensitivity disorders on the skin, these regions should be specially protected from external influences. There is an increased risk of injury, which is also often noticed late.
