Pins and Needles

Have you ever hit your “funny bone” and felt a painful burning or tingling sensation in your arm? When you hit your “funny bone”, what’s happening is that you’re actually compressing the ulna nerve in your elbow that propels these weird sensations down to the tips of your fingers.

It’s not such a big problem if you only get the sensations occasionally when you hit that spot (the tingles hardly last a minute), but what if you start to experience constant pins and needles into your arm... What does this mean?

The most common reason for ongoing pins and needles is a compression or irritation of any of those same nerves, or even the blood vessels of the arms. This irritation could be as a direct result from an injury to some part of the nerve pathway, anywhere from your neck all the way down towards the hand.

You may also experience this nerve pain as one or more of the following:

  • A shooting, stabbing, electric or burning type of pain
  • Tingling or prickling sensation down your arm
  • Potential weakness in certain muscles in your shoulder, arms or hands
  • Pain that’s worse in the cold
  • Pain that’s worse at night

What causes nerve pain?

Any trauma that impacts the nervous system can cause nerve pain. This can include repetitive micro trauma that builds up slowly over time, for example sitting with a poor posture with your neck in a stooped forward position. Or it could be caused by a single incident of nerve trauma, like a car accident with associated whiplash injury.

Nerve pain can even be from more serious (but much less common) causes like exposure to toxic substances, malnutrition, B12 deficiency or damage from an infection.

Examples tend to be the best demonstrators. Let’s take constant pins and needles into the palm of your hand. This symptom could have a number of different and overlapping causes. Nerve pressure/irritation/damage to nerves higher up than your hand is the most likely reason for the pins and needles in your hand. But other potential contributing causes could be:

  • Carpal tunnel syndrome – build up of pressure in the wrist canal can compress the Median nerve referring pins and needles into your hand
  • Cubital tunnel syndrome – irritation of the ulnar nerve as it passes beside the inside part of your elbow could refer sensation changes into your hand
  • Pinched nerve in your armpit or around your shoulder
  • Neck disorders - This occurs when certain nerves that exits your neck is compressed or irritated near your neck bones such causes can include

How does physiotherapy help with the pins and needles radiating into my arm/hand?

Our physiotherapists have an expert understanding of nerve pathways and all the potential causes of pain and pins and needles in the arm. This allows us to arrive at an accurate diagnosis, screen out more serious conditions and come up with a treatment plan to resolve pins and needles.

We will conduct a thorough assessment that will involve a detailed history of where and when the pins and needles started and what positions and activities make it feel worse and better. Next, we will do a physical exam tailored to stressing your nerves at different points in your arm and neck. For instance, moving your neck into a certain position to see if that changes the pins and needles in your arms. This will allow us to ascertain if the neck is a contributing factor and help us with the diagnosis and guide your specific treatment program.

Treatment can be thought about in three distinct stages. Part one involves offloading the compressed nerve, we can do this by utilising a number of treatment strategies

  • Releasing tight muscles surrounding the nerve
  • Splinting/taping the hand/arm/neck to offload the pressure on the nerve
  • Dry needling to help reduce muscle tightness and spasming near the nerve
  • “Tractioning” the nerve to help it decompress

Part two often involves neural mobilisation to ensure the nerve is running smoothly and heals optimally by pumping nutrients into the nerve.  Stage three involves looking at the biomechanical factors that may have contributed to the condition. Often this will involve strengthening the muscles around the problem nerve to prevent nerve irritation in the future.