Tingling

Tingling is a sensory symptom described as pins-and-needles, prickling, or crawling sensations. It is a form of paresthesia and is usually temporary and harmless when caused by momentary nerve irritation, such as a limb “falling asleep.” It can accompany numbness, and in many cases resolves quickly after changing position or movement.

Common causes include transient nerve compression or poor circulation, such as sleeping in an odd position, crossing legs, or pressing on a nerve. More persistent tingling may result from nerve entrapment (carpal tunnel, sciatica), diabetes-related neuropathy, vitamin deficiencies (notably B12), alcohol use, certain medications, infections (shingles), thyroid or kidney disease, autoimmune disorders, or chemotherapy.

Persistent or widespread tingling, tingling with weakness, facial changes, fever, unexplained weight loss, head or neck trauma, or new neurological symptoms require medical evaluation. A clinician will review history, perform a neurological exam, and may order blood tests (glucose or HbA1c, B12, thyroid function), nerve conduction studies, electromyography, or imaging to identify neuropathy, radiculopathy, or other conditions.

Treatment depends on the underlying cause. Temporary tingling from pressure or posture often improves with movement and positional changes. Persistent tingling may respond to treatments directed at neuropathic pain or neuropathy, such as certain anticonvulsants or antidepressants, vitamin supplementation if a deficiency is found, management of diabetes, and physical therapy. Lifestyle adjustments and avoidance of alcohol and tobacco are also recommended when applicable.