Tingling In Hands And Feet

Tingling of hands and feet is relatively common symptom of many medical conditions. Usually it is just a consequence of pinched nerves, which quickly goes away, but sometimes it can be related to some serious diseases. Long-term lasting or recurring tingling sensations are quite uncomfortable for the patient.


Pinched nerves

As written above, this is probably the most common cause of limb tingling sensations. Usually it's a leg is affected while sitting, when the sciatic nerve is compressed, or upper limb’s nerves are compressed during sleep. Nerves are prone to compression in certain anatomical areas where nerves fibers are located just under the skin, or in close contact with a bone. Fortunately, this irritation disappears very quickly. If you wake up with a tingling limb, it will pass away in few minutes. However, there are serious conditions that require surgery. Now I talk mainly about carpal tunnel syndrome that is caused by nerve compression in carpal canal (located in wrists of upper limbs). Carpal canal narrowing is a long-lasting process that is caused especially by heavy manual work. Definitive treatment consists of a small operation under local anesthesia; during which carpal tunnel is opened and affected nerves are released. Pinched nerves troubles may be associated with diseases of spine. These conditions may lead to compression of nerve roots exiting the spinal cord (e.g. by a spinal disc herniation).


Long lasting diabetes can damage nerves in the body. The nerves are nourished by small blood vessels that are in diabetes affected by atherosclerosis and close. Nerves are damaged by resulting ischemia and polyneuropathy arises. Lower extremities tend to be most affected. These problems typically exhibit by tingling in limbs, by leg pain and various other sensitivity disorders.


Long-term alcohol abuse leads among other things to nerve damage and to polyneuropathy. Feeling of numbness and tingling in extremities occur, affected person’s personality changes because of alcohol-related brain damage. Above mentioned symptoms and proven alcohol abuse give us quite easy the right diagnosis. In this case, the treatment is theoretically simple – to stop drinking alcohol. Vitamin of B-complex usage is a complement therapy.

Malignant diseases

Tingling in extremities can sometimes occur by a cancer. This is then called paraneoplastic syndrome. The meaning comes from the prefix para- (by-) and word neoplasia (technical term for tumor). Paraneoplastic therefore means "by a tumor". Other paraneoplastic symptoms include night sweats and weight loss. Paraneoplastic syndrome is caused by high levels of active substances and waste products created by cancer cells or by immune cells fighting the cancer.

Peripheral vascular disease

Blood hypoperfusion of lower extremities accompanied by ischemia is a relatively common consequence of atherosclerosis. Leg pain during walking emerges (so-called claudication), tingling sensations are common, as well as impaired wound healing.

Metabolic and hormonal diseases

Tingling of hands and feet may occur due to the accumulation of waste products in our body in liver failure and chronic kidney failure. Speaking about hormonal diseases, tingling of extremities may appear by thyroid gland disorders.

Multiple sclerosis

Tingling limbs may be one of many symptoms of this insidious autoimmune disease affecting nerve fibers in central nervous system.

Lack of vitamins

Deficiency of vitamins, especially of vitamin B complex, is often associated with clinical presentations of polyneuropathy including tingling sensations.


Hyperventilation (deep and rapid breathing) is related to muscle cramps and tingling of extremities. The principle of this condition is that during hyperventilation blood carbon dioxide levels fall down and this leads to a decrease in concentration of free calcium in serum. Calcium is very important for proper muscle function and its serum decrease (hypocalcemia) is reflected by tingling of extremities, and in more severe cases, by muscle convulsions.

Diagnostic approach

The diagnosis should be primarily based on patient’s medical history (known diseases, recent medication, alcohol intake, accurate description of his or her difficulties, etc). Physical examination of affected extremity and blood samples are also important. In blood test we are especially interested in level of serum blood sugar, CRP, renal parameters, liver function tests etc.). In case of suspicion of nerve functions disorders (usually a polyneuropathy), it is appropriate to perform electromyography that can evaluate conduction abilities of nerve fibers. Spinal cord and vertebral column may be examined by X-ray or computed tomography.

Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Contact: jiri.stefanek@seznam.cz
 Sources: basic text sources