28-05-2025
Ask the doctor: I have pins and needles in my fingers and jawline. What could cause this?
Dr Grant replies: Numbness and tingling is referred to as paresthesias and is generally not something to worry about unless it becomes persistent and progresses to cause other symptoms such as pain, sensory loss, or weakness involving the shoulder, arm, or hand.
The most common reason for these type of complaints is compression or entrapment of a nerve that, in its mildest form, causes intermittent symptoms. For example, carpal tunnel syndrome (CTS) is the most common mononeuropathy that causes paresthesias in the hand, when the wrist is flexed as the median nerve is compressed in the carpal tunnel of the wrist. Numbness and tingling occur in the thumb, index, middle and half of the ring finger as these are the regions supplied by the median nerve. The symptoms of carpal tunnel syndrome are usually worse at night.
A radiculopathy is commonly called a pinched root, that occurs where the nerve root exits the spine, typically at the neck and lower back. Cervical radiculopathy is a common cause of both acute and chronic neck pain. Trigeminal neuralgia is common and causes typically one-sided (unilateral) sudden, severe shooting pain in the jaw, teeth or gums.
Always consider the possibility of dental infection, impacted wisdom teeth or gum disease. Therefore, a trip to the dentist might be a good idea!
There are many possible causes of radiculopathy. Keeping a diary of your symptoms, including the onset, duration, severity, associated symptoms (if any), what brings it on and what may relieve it, can be very helpful in trying to get to a diagnosis.
Your age, gender (women are more commonly affected), family history and personal medical history are all important factors. A routine set of blood tests including vitamin B12, thyroid function tests and diabetes testing should be considered.
It is unlikely that your two complaints are related, as the anatomy of the nerve supply is different. As you seem to think a certain exercise in the gym involving weight lifting brought on your symptoms, clearly you should stop doing that particular exercise for now and wait to see if your symptoms resolve over time.
One of the common questions GPs get asked when patients present with paresthesias is, could this be Multiple Sclerosis (MS)? In general, MS causes vision problems, difficulty walking or speaking correctly, cognitive difficulties, numbness and tingling, muscle weakness, fatigue and other problems. MS is an auto-immune disease when the immune system attacks and damages nerve cells and their connections in the brain and spinal cord. Working with your doctor over time will determine if referral to a consultant neurologist is appropriate or necessary.
Features suggestive of MS that are highly characteristic of the disease include:
1. Typical age of onset between 15 and 45 years
2. Relapses and remissions
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3. Optic neuritis causing pain on eye movements or temporary loss of vision
4. Fatigue
5. Lhermitte's sign, which is a sudden buzzing sensation like an electric shock that run down the back of your neck and spine and may radiate into an arm/leg. It is usually triggered by bending or flexing your head forward towards your chest. It generally lasts a couple of seconds but can be very intense.
6. Internuclear ophthalmoplegia causing double vision and nystagmus, which is involuntary side-to-side rapid eye movements that last only a few seconds.
7. Uhthoff's phenomenon, which is short-lived (less than 24 hours), of worsening of symptoms in response to an increase in core body temperature. The classic example is motor symptoms or difficulty moving your arms/legs while trying to get out of a hot bath.
Dr Jennifer Grant is a GP with Beacon HealthCheck
