Symptom · Arms & hands

Tingling (pins and needles)

Also known as: pins and needles, paraesthesia, paresthesia

Prickling, buzzing or crawling sensations without an outside cause, produced when sensory nerves fire abnormally. Brief tingling from pressure is universal; persistent or spreading tingling has the same causes as numbness and is investigated the same way.

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What it is

Prickling, buzzing or crawling sensations without an outside cause, produced when sensory nerves fire abnormally. Brief tingling from pressure is universal; persistent or spreading tingling has the same causes as numbness and is investigated the same way.

Common causes

Pressure on a nerve or reduced blood flowCrossed legs, tight straps, cold hands.
Carpal tunnel syndrome and ulnar nerve entrapmentTingling in specific fingers, worse at night or leaning on the elbow.
Cervical or lumbar nerve root irritationTingling down an arm or leg with neck or back pain.
HyperventilationTingling around the lips and in both hands during panic or over-breathing.
Peripheral neuropathyDiabetes, alcohol, B12 deficiency, some medicines.
Migraine aura

Less common causes

Stroke or TIASudden one-sided tingling with weakness or speech difficulty.
Multiple sclerosisTingling that spreads over days, sometimes an electric shock down the spine on bending the neck.
Low calcium or other electrolyte disturbanceTingling around the mouth and cramps.
Vitamin B12 deficiencyTingling feet with unsteadiness and anaemia.
Raynaud's phenomenonFingers turn white then blue and tingle in the cold.

Often occurs with

Seek urgent care if

  • Sudden tingling on one side with weakness, face droop or difficulty speaking
  • Tingling spreading rapidly up the legs or arms over hours to days
  • Tingling with severe headache, neck injury or loss of bladder control

Conditions to read about

How it is investigated

Educational content. This page explains what a symptom can mean so that the anatomy and the medical reasoning make sense. It cannot tell you what is causing yours: only a clinician who can examine you and order tests can do that.