Pins and needles: what causes them, how long they last and when to see a GP

The NHS describes pins and needles as a pricking, tingling or numbness sensation that happens when the blood supply to the nerves is cut off. This is usually when you sit or sleep on part of your body, which is why a leg or arm can feel as though it has gone to sleep.

It most often affects the arms, hands, legs and feet, and the NHS says it usually stops as soon as the weight is taken off and the blood supply returns to the nerves. Everyone can get it, and the NHS says it only lasts a few minutes.

The medical word for the sensation is paraesthesia. Brief episodes caused by pressure on a nerve are not a sign of illness. What matters is when pins and needles is constant, keeps recurring or comes with other symptoms.

Tingling in the hands is a common reason for people to search about pins and needles in pregnancy. The NHS lists being pregnant as one of the risk factors for carpal tunnel syndrome, where the carpal tunnel inside the wrist swells and squeezes a nerve (the median nerve). It causes tingling or pins and needles, numb hands, an ache in the fingers, hand or arm, and sometimes a weak thumb or difficulty gripping.

The NHS says these symptoms often start slowly, come and go and are usually worse at night. Carpal tunnel syndrome sometimes gets better by itself in a few months, particularly if you have it because you are pregnant. Wearing a wrist splint at night keeps the wrist straight and relieves pressure on the nerve, although you may need to wear one for up to 6 weeks before it starts to feel better.

Mention new or persistent tingling to your midwife or GP, as the cause needs to be identified. Tingling that is sudden, affects one side of the body or comes with a severe headache, face drooping or weakness is not a normal pregnancy symptom and needs emergency care.

Short episodes come from pressure on a nerve. When pins and needles keeps happening or lasts a long time, the NHS lists several possible medical causes and advises you not to self-diagnose but see a GP if you are worried. The pattern of other symptoms can offer clues.

The NHS also says long-lasting pins and needles may be caused by treatments such as chemotherapy, some medicines (such as HIV medicine, medicine to prevent seizures or some antibiotics), toxic substances such as lead or radiation, poor diet, a trapped nerve in the back or neck, nerve damage after an injury or illness, and drinking too much alcohol.

The NHS page on vitamin B12 and folate deficiency lists pins and needles among the problems a deficiency can cause, alongside extreme tiredness, a sore red tongue and muscle weakness. It adds that some of these problems can happen even without anaemia.

The NHS says pins and needles from sitting or sleeping on a body part only lasts a few minutes. Moving, shaking the limb out or taking the weight off it lets the blood supply and nerve function return.

Pins and needles that is constant, keeps coming back or lasts a long time is different. The NHS says to see a GP in these cases. Carpal tunnel syndrome, for example, can take months to get better and the NHS says that you may need a splint for up to 6 weeks before it helps. Peripheral neuropathy is described as depending on the cause; some cases improve with time if the underlying cause is treated, whereas in some people the damage may be permanent or may get gradually worse.

On its own the sensation is pricking, tingling or numbness. The NHS list of conditions helps explain which accompanying symptoms matter. Tingling with a weak thumb or difficulty gripping points towards carpal tunnel syndrome. Tingling in the feet with loss of balance, weakness or a cut or ulcer on the foot that is not getting better should be seen by a GP, according to the NHS page on peripheral neuropathy.

The NHS says peripheral neuropathy may cause numbness and tingling in the feet or hands, burning, stabbing or shooting pain, loss of balance and co-ordination, and muscle weakness, especially in the feet. These symptoms are usually constant, but may come and go.

See a GP if you constantly have pins and needles or it keeps coming back. The NHS says it is important to see a GP early with pain, tingling or loss of sensation in the feet, loss of balance or weakness, or a cut or ulcer on your foot that is not getting better, and that people at highest risk of peripheral neuropathy, such as people with diabetes, should have regular check-ups.

Numbness is also a stroke symptom. The NHS says to call 999 now if you think you are having, or have had, a stroke or have had signs of a stroke within the last 24 hours, even if they have stopped. Signs include face weakness (one side of the face may droop), arm weakness or numbness in one arm, speech problems, weakness or numbness down one side of the body, blurred vision, confusion, dizziness and a severe headache. The easiest way to remember is FAST: face, arms, speech and time to call 999. Do not drive yourself to A&E.

The NHS says any treatment you might need for pins and needles will depend on the cause. For brief episodes, taking pressure off the limb is enough.

For carpal tunnel syndrome, the NHS lists a wrist splint at night, cutting down on activities that bend the wrist or grip hard, painkillers for short-term relief (with little evidence that they treat the cause) and hand exercises. If a splint does not help, a steroid injection may be offered, and surgery usually cures it if it is getting worse and other treatments have not worked. For peripheral neuropathy, the NHS says treatment depends on the cause, such as better blood sugar control if you have diabetes, stopping smoking and cutting down on alcohol, and that nerve pain may be treated with prescribed neuropathic pain medicines because standard painkillers often do not work.

A GP can take a history, examine you and arrange blood tests, for example for diabetes or vitamin B12. If the cause is unclear, the NHS says nerve conduction tests of the wrist, scans such as ultrasound or MRI, or a neurologist referral may follow. In many areas you can refer yourself to NHS community musculoskeletal (MSK) services for physiotherapy for back or joint problems without a GP referral.

Some people choose a private neurologist or physiotherapist and arrange nerve tests or scans privately. The assessments are the same in principle; the difference is mostly waiting time and cost.