Diagnosis
The basis for the diagnosis is always a detailed anamnesis. When do the symptoms appear? Are they only temporary or permanent?
Are there any accompanying symptoms? The anamnesis is followed by a physical examination. The doctor will look at the leg, examine the spine and perform a brief neurological examination.
Depending on the suspected diagnosis after these two steps, further measures are taken. If a disease of the central nervous system is suspected, an MRI is ordered by the brain. If the doctor suspects a herniated disc, an imaging of the spine is performed.
Associated symptoms
Depending on the cause of the nerve disorder, the tingling in the leg is accompanied by numerous other symptoms. These can be pain on the one hand. These are also caused by nerve irritation along the limbs.
If the cause is a herniated disc in the lumbar spine, back pain occurs as accompanying symptoms. If the herniated disc is more extensive, paralysis or disorders of the bladder and rectum function can always occur. If a disease of the central nervous system, for example multiple sclerosis, is hidden behind the tingling leg, the patient suffers from other neurological symptoms such as impaired vision, paralysis or sensitivity disorders in other areas of the body.
Fibromyalgia is also accompanied by pain in the musculoskeletal system as further symptoms. Polyneuropathy of the legs, e.g. due to alcohol or vitamin B12 deficiency, often leads to tingling legs as well as gait disorders. Patients who report tingling in the leg also report pain as an accompanying symptom.
This often cannot be differentiated exactly. The tingling in the leg is usually caused by nerve damage. This can only be temporary.
Nevertheless, nerve damage usually leads to pain. However, nerve pain is often not perceived as a classic backache or headache. Most patients experience them as much more unpleasant than a burning and stabbing sensation.
With regular painkillers (such as ibuprofen or paracetamol) such nerve pain is also difficult to treat. Therefore, one should first of all search for the cause of the pain. If it is not possible to treat them, or only inadequately, special nerve painkillers (usually antidepressants or neuroleptics) are used.
Situation-dependent tingling in the leg
Tingling in the legs combined with an obsessive urge to move and restless legs are indications of restless legs syndrome (RLS). The symptoms typically occur mainly at night and improve with movement. The causes of the disease have not yet been fully researched; it is most likely to be due to a disturbed dopamine metabolism in the brain.
In rare cases, there are other causes that favour the development of restless legs syndrome, such as pernicious anaemia, terminal renal failure, Parkinson’s disease, rheumatoid arthritis, special drugs such as antidepressants or neuroleptics, or even pregnancy. The diagnosis can usually be made based on the typical symptoms. Often an attempt is also made to start a therapy with L-Dopa.
In most cases, the symptoms improve quickly. But the cause of a nightly tingling sensation in the legs can also be far less serious. A skin nerve is irritated by a wrong sleeping position.
This hypersensitivity reaction is reported back to the brain and perceived by the patient as a tingling sensation. The cause of a leg tingling when lying down is a nerve disorder. In the case of meralgia paraesthetica, the outer skin nerve on the thigh is constricted under the inguinal ligament.
This is favoured by too tight clothing, pregnancy and overweight. Too tight seat belts in cars are also responsible for this. Symptoms are discomfort on the outer side of the front thigh.
At the beginning these usually occur when lying down or when the hip joint is stretched. If the hip joint is bent, the symptoms usually improve immediately. A surgical decompression of the nerve is possible.
However, triggering factors should first be eliminated. Often the symptoms also regress spontaneously. Before considering an operation, it is also possible to inject painkillers (local anaesthetics) or cortisone with a thin needle into the area around the nerve.
A general pain therapy with non-steroidal anti-inflammatory drugs (e.g. ibuprofen) is also possible. If the leg tingles while sitting, the cause is usually nerve damage caused by mechanical pressure. If one sits in an unfavourable sitting position for a particularly long time, the legs start to tingle.
This is a relatively typical symptom. It is mostly harmless. If you change your sitting position or stand up and move, the tingling quickly disappears because the pressure on the nerve is reduced.
Nevertheless, if the symptoms occur more often, it is advisable to consult your family doctor. When you fall asleep, you may also experience occasional tingling in your legs. In most cases, this is due to a short-term disturbance in nerve conduction.
This is often caused by an unfavourable sleeping position. The symptoms disappear again quickly with a change in movement. Nevertheless, more serious diseases can also be behind it.
Warning signs are, for example, a frequent occurrence and other accompanying symptoms. Even if the leg tingling does not recede spontaneously, a doctor should be consulted. Tingling in the legs after exercise can be caused by a lack of magnesium or potassium.
But it can also be a harbinger of sore muscles. In most cases it is therefore harmless. However, if it occurs frequently or does not recede any more, it is advisable to consult your family doctor. There can always be other causes, e.g. a disturbance of the nerve conduction. After a detailed anamnesis and physical examination, the general practitioner can usually give the all-clear.
