Paresthesia
We’ve all had that feeling of “pins and needles” after your leg has “fallen asleep.” Or maybe you have been awakened in the middle of the night to an utterly numb arm, only to have it begin tingling like mad after you clumsily readjust. These are the more common forms of a condition called paresthesia that everyone can relate too. However, they are very mild compared to the other sensations one can experience.
For example, perhaps you feel random burning sensations throughout the body. Or like me, a burning patch of skin on your leg or arm with no apparent cause or even visual indication that there is a problem. You may also have to endure random itching or a feeling like something is crawling on your skin.
To make matters worse, paresthesia is a fairly common symptom of fibromyalgia. As if dealing with all the other invisible fibro symptoms wasn’t hard or painful enough, paresthesia gets thrown into the mix as well.
Paresthesias in Fibromyalgia
Fibromyalgia and chronic fatigue syndrome are both associated with paresthesias, including the painful kind. They can be of any severity and get more or less painful over time. In chronic fatigue syndrome, we have no real research on paresthesias but a wealth of anecdotal reports.
As in fibromyalgia, they can range from mild to severe and can show up just about anywhere. In fibromyalgia, this symptom is firmly established by research as well as by anecdotal reports from people with the condition. A 2009 study suggested that people with fibromyalgia who also smoke cigarettes tend to have more severe pain from paresthesias.
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(This is just one of several fibromyalgia symptoms that smoking may exacerbate.) Quitting smoking may help alleviate the pain, as well as other smoking-related symptoms. A 2012 study suggests that carpal tunnel syndrome (CTS) is more common in people with fibromyalgia than in the general population. CTS is a painful and potentially debilitating condition that involves nerve compression and/or swelling in the wrist.
It’s especially common in people who spend a lot of time on the computer or playing video games, and in checkers at the grocery store. The researchers who found this link warned that CTS can be hard to spot in people with fibromyalgia because the pain can be mistaken for paresthesias. If you have pain in your hands, especially nerve pain or nerve “zings,” and especially if they get really bad when you’re asleep or trying to sleep, you may want to ask your doctor to check for CTS. Left untreated, it could get significantly worse over time.
Fibromyalgia referred to as a disease that affects the central nervous system
It’s pretty common to hear fibromyalgia referred to as a disease that affects the central nervous system. One of the worst features of fibro is that its connection to the nervous system means it amplifies pain that shoots through the body.
This is an important note because the National Institute of Neurological Disorders and Stroke (NINDS) explain that paresthesia is usually painless. At first I thought this was a terribly misleading thing to say. But then I asked a friend who does not have fibromyalgia or any kind of pain sensitivity. She confirmed that the tingling feeling we all experience does not hurt at all.
I was shocked to hear this because I thought everyone experienced that sensation with a significant degree of pain, albeit brief. This made me wonder, then, what exactly is paresthesia and how can it be treated?
Causes of Paresthesias
Paresthesias are most often caused by damage to peripheral nerves (those in the arms and legs) or pressure on those nerves, which may be caused by inflammation or injury. They can also be caused by chemotherapy drugs. However, most of the time the cause is unknown, In fibromyalgia and chronic fatigue syndrome, one hypothesis is that they’re the result of generally heightened sensitivity of the nerves as well as an amplified pain response in the brain.
However, with further research, more possibilities are arising. Another more recent line of inquiry involves damage to small nerve fibers, which are in your skin, organs, and the nerves of your arms and legs (peripheral nerves). Their job is to provide sensation for your skin, such as when you touch something, and to control the function of your autonomic nervous system. That includes all of the automatic things, such as regulating heart rate, breathing, and body temperature. Damage to these nerves is called peripheral neuropathy.
Paresthesia Symptoms
Certain fibromyalgia symptoms can often overlap with chronic paresthesia, sometimes making it difficult to diagnose. However, there are separate symptoms, such as:
- >>Crawling feeling on the skin
- >>Sensitive to the touch
- >>Burning sensation on the skin, particularly on the extremities
- >>Itchy skin on a particular area of the body
- >>Pain in a certain area of the body
- >>Numbness in the extremities or other areas of the body
Treating Paresthesia
The single greatest problem associated with fibromyalgia is our inability to cure it. The only option is to attempt managing the symptoms. Fortunately, paresthesia is usually a symptom that is treatable once the source is identified. However, you may run into problems if the source is actually the fibro itself.
Nevertheless, the NINDS explains that the prognosis “depends on the severity of the sensations and the associated disorders.” Finding the source often involves tests such as MRI, X-ray, or blood test. Whether or not you have fibromyalgia, it is important to seek diagnosis and treatment for it in the event that it is related to nerve damage, tumor near the spinal cord or brain, undiscovered mini-strokes, and more.
After identifying the source and possibly treating the source, paresthesia may go away on its own. However, some treatment options also include exercise, massage, anti-inflammatories, or even much stronger medications.
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References:
- Gupta D, Harney J. Small fiber neuropathy demonstrated in pain syndromes. Poster session presented at Annual Meeting of the American Academy of Neurology; 2010 Apr 10-17; Toronto, Ontario.
- Liptan, GL. Fascia: A missing link in our understanding of the pathology of fibromyalgia. Journal of bodywork and movement therapies. 2010 Jan;14(1):3-12.
- Nacir B, Genc H, Duyur Cakit B, et al. Evaluation of upper extremity nerve conduction velocities and the relationship between fibromyalgia and carpal tunnel syndrome.Archives of medical research. 2012 Jul;43(5):369-74.
- Pamuk ON, Donmez S, Cakir N. The frequency of smoking in fibromyalgia patients and its association with symptoms. Rheumatology international. 2009 Sep;29(11):1311-4.
- Uceyler N, et al. Brain. 2013 Jun;136(Pt 6):1857-67. Small fibre pathology in patients with fibromyalgia syndrome.
- Odd Nerve Sensations in Fibromyalgia & Chronic Fatigue Syndrome by Adrienne Dellwo via Verywell Health