possible causes for long term pins and needles?

[MyVisionsComeFromSoup]

I have pins and needles in my legs (particularly my feet, heels especially) and arms, mainly the outside of my hands. Have had lots of neuro investigations, which showed nothing in particular, other than "age related wear and tear" in my neck.

Two years later I'm seeing an orthopedic surgeon as I also have pain in my neck, upper back, shoulders and arms. He's looked at my most recent MRI and doesn't think the pins and needles are to do with any physical nerve compression. He's sorting a nerve root injection to hopefully help with the pain, but no the pins and needles.

So, assuming the ortho is right, what are some possible causes for the pins and needles, that I can get my GP to investigate?

Dr Google has suggested diabetes (have PCOS so that's a possibility), and B12 deficiency (had that tested couple of years ago, and it was at the lower end of normal, so again, that might be a possibility) - anything else anyone can throw into the mix? GP is very likely to want to do a full range of tests to make up for the fact that the previous GP was particularly unhelpful (told me she wasn't going to let me have neck surgery as she'd never known it to help anyone when all I had asked was what could be done about the pain, and just kept on adding new painkillers onto my prescription), so it would be useful to have a pre-prepared list of things to suggest, so I get them all at once.

Also, might it be being made worse with the combination of meds? I know that can sometimes happen - I'm taking pregabalin, naproxen (and omperazole), paracetamol and amitryiptyline rattling like a chemists shop

TIA

It's a shot in the dark, but I had pins and needles in my hands and feet which proved to be lack of Vitamin D. Took one tablet a day for about 6 months and it's never reoccurred.

Was also going to suggest vitamin d, I had all sorts of pins and needles and strange skin symptoms due to v low cut d levels

You're on quite a lot of meds - have you had liver function tests performed? I'd make an appointment with your GP and ask for a full liver panel to be done, as sometimes liver damage can cause the symptoms you describe.

Also, if you've been taking paracetamol regularly, LFTs would definitely be a good idea.

I would also get a full blood test done to rule out any autoimmune conditions. I have lupus, Raynaud's and Sjogren's and one (or all) of them causes me to have pins and needles like you describe.

Amongst other symptoms - DD suffers numbness and tingling of fingers, hands, arms, legs & feet (predominantly one side). Her neuro consultant is treating it as a variant of migraine. As a child she suffered from mainstream migraine (vomiting, vision disturbance, headaches). She is taking same meds as you.
She also suffers from foot pain and is having weekly physio on her sciatic pathway.

thanks for that - I can probably rule out some things (paracetamol only for the past 6 weeks; potentially liver as the pins and needles pre-date the meds, although the meds might be making things worse).

Hadn't considered non-standard migraine - all three DDs get migraines which are related to a medical condition which we think has come down through my side of the family; also Sjorgens is I think potentially related to the same group of conditions (Ehlers Danlos and PoTS).

I have the start of a list then, we can work down it

Vitamin B12 deficiency? Mite common than you think and pins and needles is a classic symptom.

I have POTS and Complex Regional Pain Syndrome and my whole family is just about to have genetic testing for EDS.

I was investigated over and over again by neurology for pins and needles and numbness (among other things), but it wasn't until I was diagnosed with POTS, fairly recently, that the penny dropped. In my case it seems to be another manifestation of autonomic dysfunction. I also get really painful stinging skin (as if it's been scalded and I can't let anything even brush lightly against it, it's so painful) either in patches or a whole hand, foot, leg or arm in one go, but I think that's more down to the CRPS.

I also suffer from complex migraine and that causes pins and needles too.

I would look into the possibility of Vit D or B12 deficiencies first, to rule them out and then perhaps start asking more questions more relating to your family's medical history. Both EDS and POTS can both be responsible for a wide range of weird symptoms.

Oh and I don't get on with omeprazole, especially at higher doses. It causes a sort of whole body restless legs syndrome in me for some reason. So that's also worth considering.

Just read all that back - I sound like I'm dropping to bits.

aah moosemama - PoTS and EDS in the family (DD2 is a prolific fainter) and I hadn't come across pins and needles as a symptom before. Might have to revise which GP I see if I'm adding that to my list, as most of them at our practice run a mile at any mention of PoTS. It's hypermobility type EDS the DDs have, so not the really serious types.

a very gentle [hug] for the CRPS though , that's nasty.

Ha! Sorry, but that made me laugh. I spoke to a new GP at our surgery today and they basically panicked, backtracked and refused to do anything without speaking to another doctor when they realised I had PoTs. I am in a ridiculous loop where my cardiologist/electrophysiologist prescribed meds for me two months ago, but the paperwork for shared care has been bouncing around in the system so much since then that the GP/Reg I was working with at our surgery left and I have to start all over again with a new one - who refuses to prescribe off-licence meds, when there are no on-licence meds for PoTS. It's a total farce! You have to laugh or you'd cry - although I may actually have done that out of frustration when I put the phone down today, especially as I had only just avoided fainting in the school playground at drop-off this morning and I really hoped the call was to say they'd finally got my meds sorted.

They're not 100% sure what type we are. We're a bit of a mixed bunch really. Mum is the worst affected and has had three joints replaced and needs one more but doesn't want the op, plus all sorts of other problems including mitral valve prolapse and aortic dilation (hence them wanting us all checked). I suspect she has classic type. I reckon I'm hypermobile type and my middle son has JHS, so most likely hypermobile type there as well, but they want us all checked just in case there's cross-over and we have more serious, as yet unknown problems like Mum.

Not sure how common the pins and needles are as an autonomic thing, but the consultant I saw privately said he had come across it a fair bit. I also have a lot of weird autonomic symptoms and adrenaline issues, plus the CRPS, which is all basically sympathetic nervous system wonkiness as well.

Thankfully the CRPS is mostly under control, as it was caught just before it reached the most serious stage. It only tends to flare when I let myself get exhausted/stressed these days. Unfortunately, it's another thing that GPs tend not to know much about. Mine were hopeless and hadn't a clue what was wrong, so assumed it must be all in my head - as they are wont to do. I was 6 months on crutches before anyone worked out what was wrong.

I had pins and needles as my presenting symptom of coeliac disease.

I had horrible pins &needles in my hands + feet, also carpal tunnel syndrome both wrists plus loads of other seemingly unrelated health issues, before hypothyroidism was found.
In addition to Thyroid Function Testing, I had bloods:
B12 & folate, FBC + Iron stores, Vitamin D, and fasting glucose plus Hb1ac bloods for diabetes. Ferritin was found to be very low and I was prescribed a course of iron sulphate.
I've read similar to DuckWaddle 're coeliac disease so maybe worth asking your GP for that blood test also? My GP was very thorough with blood test investigations.
Hope you get sorted OP. Btw pins + needles / neuropathy in hands / feet very much better since medicated for hypothyroidism. Felt like my feet were burning continuously before diagnosis, horrible :(

Carbon monoxide poisoning?

Do you drink much alcohol? Thiamine (b1) can often be depleted rapidly if you drink alot and can cause pins and needles in your hands and feet.

Anaemia and vitamin b deficiency causes it here.

thanks all for your suggestions, I have a nerve root injection in my neck in a few weeks, then one in my lower back "at some point", so if they don't help, I'll be off to the GP with a list.

back for any more suggestions - just got my blood tests results back and everything is "normal, no further action", and that I would need to speak to the doctor if I wanted to discuss the actual numbers (I was thinking that eg B12 might be at the bottom end of normal, so supplementing that might help).

Nerve root injections have made no difference, the pain doctor will discharge me back to the orthopedic surgeon next month, who will probably discharge me back to the GP, as there's not much else he can do.

So - any more thoughts? I've had full blood count, vits B12 and D, thyroid, liver function, the diabetes blood one, and i think a couple of others I can't remember offhand. I don't really want to go back to the neuro as he was pretty dismissive (I felt), though that may just be his manner. He's the only one locally, and is pretty well respected, so I assume he knows his stuff, plus also he may have been more forthcoming with my previous GP, who didn't see the need to share anything with me, I was left with the neuro shaking his head and saying "oh dear, what shall we do with you then", which made me feel about 5 .

There's nothing obviously causing my symptoms, but they're getting worse, and I'm trying really hard not to stress and panic as that will make things worse.

oh, saw the suggestion of coeliac - we didn't talk about that. Would that flag up in any of the blood tests as an issue? Could i try cutting out gluten for a couple of weeks and see if it makes a difference, or is that a bad idea?

OP do you have a carbon monoxide detector?

Hi
A friend with pins and needles symptoms was finally diagnosed with MS after some years of being fobbed off. You seem to have had lots of tests though but your post caught my eye. Hope you find some answers soon.

Isall - yes we do have carbon monoxide detector and once I replaced the batteries yesterday that's OK.

Ilove - MS was one of the first things they panicked about (that and a stroke), so I know that the major serious things have been ruled out (or at least were 2/3 years ago) thankfully.

Back to the GP I think.

It could definitely be B12 as Omeprazole is known for being a cause of B12 deficiency.

Some good reading here to give you some information and ideas of questions to ask your GP.
I'd recommend you find out your actual result and the range that the lab uses, as a lot of GP's don't follow the up to date guidance of treating the symptoms of B12 when in range, despite being symptomatic.

results and ranges are back:

B12 right slap bang in the middle (429 range 197-771)

Vit D - 53 - optimum level is 75-200/50+ is sufficient, depending on source. Will check this with GP though.

TSH - 1.23 range 0.3-3.94

Diabetes (HbA1c) - 5.3% - under 6% is normal, 6.5%+ is diabetes

Everything else (in the full blood count) looks OK, apart from:
Serum ferritin level which is 22 with a range of 13-150. Dr Google tells me that this might be iron deficient anaemia (in that I have low stores of iron) - am I reading this correctly? The folate level was 15.2 (range 4.6-18.7) so looks good.

If so, then my answers to the the "Have you got Coeliac Disease?" questionnaire are right, and it looks like I should get tested for coeliac disease. So, I have a GP appointment booked to check that out.

A final thing was part of the liver function tests - the serum total protein level was 64 with a range of 64-83 - Dr Google isn't being particularly helpful with this one What does this measure (in laymans' terms) and what does my low count actually mean?

re-reading earlier posts - I can see several of you have mentioned low ferritin and coeliac, thankyou (brain fog means I don't concentrate and remember stuff at all well atm).