Most people are familiar with the pins-and-needles sensation that can occur when sitting in a certain position causes a foot or leg to fall asleep. When the nerves are compressed for too long, they stop sending messages to the brain as they normally would, causing numbness. Once pressure is alleviated by changing positions or moving around, the sense of feeling slowly returns to the body part. This phenomenon is known as temporary paresthesia, and it also can sometimes signal a serious condition, such as spinal stenosis or a pinched nerve.
Centers for Neurosurgery, Spine & Orthopedics (CNSO) is New Jersey’s most comprehensive spine and neurosurgery center. Learn more about paresthesia and what conditions it might indicate.
What Is Paresthesia?
Paresthesia is a skin sensation caused by nerve damage or compression of a nerve. While it is most common in the hands, arms, legs, and feet, it also can occur in other parts of the body. Paresthesia might feel like:
- A pins-and-needles sensation
Temporary pressure on a nerve can cause paresthesia. This might happen when a person sits in a certain position for too long or falls asleep on their arm. Certain medical conditions, however, can cause chronic paresthesia.
Causes of Chronic Paresthesia
Paresthesia that comes and goes regularly could be a sign of neuropathy (nerve damage) or a pinched nerve. Often, pinched nerves are caused by spinal stenosis, a narrowing of the spinal canal that typically develops from wear and tear on the spine that happens naturally as a person ages. Spinal tumors or cysts also might compress the spinal cord nerves and cause paresthesia.
What Is Spinal Stenosis?
The spinal cord is located within the spinal canal and is protected by the series of vertebrae in the neck and back. Nerve roots branch off from the spinal canal and exit the spinal canal through the small openings between each vertebra, known as foramina.
With spinal stenosis, there is less space in the spinal canal, so the nerves may get irritated, compressed, or pinched. This can lead to symptoms such as:
- Neck or lower back pain
- Weakness in the hands or feet
- Numbness, tingling, or pain that radiates down the arms or legs (radiculopathy)
- Loss of balance or coordination
- Loss of bladder or bowel function
Paresthesia associated with spinal stenosis often is accompanied by the need to lean forward at the waist to relieve the pain. The pain also may be worse when a person is standing or walking for long periods. Spinal stenosis symptoms usually start slowly and get worse over time.
Risk Factors for Spinal Stenosis
While spinal stenosis can affect anyone, it is most common in adults over the age of 50. That is because stenosis often is caused by age-related changes to the spine, such as osteoarthritis, degenerative disc disease, and bone spurs. All these conditions can compress the spine and create less space for the nerve roots to exit the spinal canal.
Treating Paresthesia and Other Spinal Stenosis Symptoms
Spinal stenosis typically is diagnosed through a physical examination and imaging tests. A provider may check a patient’s reflexes, muscle strength, and range of motion. They may use X-rays, magnetic resonance imaging (MRI), computed tomography (CT) scan, or electromyogram (EMG) to identify the root cause of paresthesia and check for issues such as osteoarthritis or bone spurs of the spine.
Spinal stenosis is not reversible, but fortunately, it often can be managed without surgery. Conservative treatment options for spinal stenosis include:
- Heat and ice: A heat pack can relieve stiffness and pain from osteoarthritis, while ice can reduce inflammation.
- Physical therapy: Working with a physical therapist can help a patient strengthen the muscles, tendons, and ligaments in the back, improving flexibility and spine stability.
- Oral medications: Nonsteroidal anti-inflammatory medications (NSAIDs) can decrease pain and inflammation.
If these treatments do not relieve paresthesia, an epidural steroid injection can help relieve nerve irritation. Spine surgery is recommended only if back pain does not resolve with less invasive treatments.
If surgery is recommended, the neurosurgeon or orthopedic spine surgeon will discuss options and explain the risks and benefits. The following surgical options are common when treating spinal stenosis:
- Laminectomy – By removing the bony overgrowth causing the stenosis, the neurosurgeon creates space within the spinal canal for the previously crowded spinal cord and nerves. The nerves now have more room to move so as the nerves heal, the symptoms quickly resolve.
- Spinal Fusion – In some cases, there is a significant amount of diseased brittle bone that needs to be removed. Vertebral bones may need to be realigned if there are pathological curvatures. In either case, when the spine is unstable the neurosurgeon must also stabilize the spine so it can function as a stable unit by creating a fusion. Fusions require bone grafts and hardware for lifelong stability.
Find Spinal Stenosis Treatment at CNSO
Patients with paresthesia caused by spinal stenosis can find comprehensive care at Centers for Neurosurgery, Spine & Orthopedics (CNSO) in northern New Jersey. The experienced medical team includes neurosurgeons, orthopedic spine surgeons, physiatrists, rehabilitation specialists, interventional pain management physicians, and certified physical therapists. These providers take a conservative approach to care, working collaboratively to treat patients with non-surgical interventions whenever possible. CNSO has convenient locations throughout northern New Jersey so patients can receive best-in-class spine care without having to travel far away. For more information about CNSO or to request an appointment, contact CNSO today.