It's not about the time when you sat in an armchair without moving your hands for a while, nor is it when you sat on a stool, crossed your legs and then got engrossed in a conversation and suddenly decided to stand. Such occasions and many more, like squatting on a hard floor in an unaccustomed posture, are a result of physiological causes— weight of the limb temporarily compresses the artery supplying blood to the nerve bundle, both of which are relatively superficial.
This persistent pressure occludes the circulation, the area becomes momentarily 'dead' and when suddenly the pressure is relieved, the nerve impulses fire in rapid succession in consonance with the restoration of trickling blood supply. In minutes, symptoms vanish and recovery is complete. This is normal. Rarely, prolonged pressure exerted through the muscle and bone on the neurovascular bundle, like during deep slumber in an intoxicated state (alcohol ) which doesn't allow movement, can cause anatomical and functional damage and a resulting paralysis of the muscles that are supplied by the nerve.
Classically seen in the forearm—colloquially called Saturday night Sunday morning paralysis (binge), this condition needs physiotherapy, drugs and time to repair.
Peripheral neuropathy is the pins and needles in the hands and feet that is caused by the toxic action of diseases, drugs, intoxicants etc on the long nerves in the body. The longest nerve fibres—those supplying the glove and stocking area are the ones that get compromised. Diabetes, nicotine and alcohol abuse, heavy metal poisoning and other metabolic conditions can cause irreversible damage, producing this burning hands and feet syndrome. Now this symptom can be tormenting, chronic and would certainly need medication.
Unfortunately, complete alleviation of this is difficult and one also needs to address the primary cause.
It is when tingling and numbness is focal or limited to a limb or wrist or back of the thigh that one has to look for pathology in and around the spinal cord. The nerve root, as it emerges from the spinal column, can get impinged (pressed ) by a slipped disc (sciatica), compressed by an abnormal bony spicule (spondylosis) or even get entrapped in an infection or growth. This kind of unilateral (one-sided) symptom needs prompt attention. Treatment is then directed towards the pinched nerve and relief is directly proportional to the success in treatment of the root cause.
However, don't let me "needle" you with fear or "pin" you down to a diagnosis. It is only when such complaints becomes persistent and inexplicable that it demands attention. Neuronal sensations can be pleasurable or painful, but pins and needles can be irritating and then worrisome.
For in the "Ram Leela" of the nervous system, everything is so well wired that this short circuit of impulses can be tougher than 'onions' and 'Campa Cola' to resolve.
(Dr Hemant Thacker is a Consultant Physician & CardioMetabolic Specialist attached to south Mumbai hospitals. Email:dochpt@gmail.com)
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