What Does Tingling in Your Hands and Feet Mean?

Tingling in your hands and feet can feel like tiny electrical sparks, pins and needles or the static sensation you get when a body part “falls asleep.” As the feeling passes, you might notice numbness or extra sensitivity.

Most people experience this from time to time after sitting in one position too long, crossing their legs or sleeping on an arm or hand. That temporary “falling asleep” sensation happens when pressure briefly slows blood flow or compresses a nerve — and it usually goes away once you move around.

But tingling that happens often, lasts longer or appears without an obvious cause may signal something else.

“There’s no such thing as normal tingling,” says Anil Neelakantan, M.D., FAAN, a director of neurology and neurosurgery with Sutter Health. “Something is causing the tingling.”

So, what could be causing it, and when should you see a doctor? 

Causes of Tingling in Hands and Feet 

When you’re feeling tingling or numbness in your fingers and toes, it means communication between your brain and the nerves in your skin has been disrupted. Sometimes this disruption is temporary — such as when pressure on a nerve causes a limb to “fall asleep.”

However, ongoing or unexplained tingling is most commonly linked to nerve damage, known as neuropathy.

Minal Bhanushali, M.D., a neurologist and the chief of comprehensive neurology at Sutter Health, explains that there are three main categories of neuropathy causes:

• Genetic causes. Hereditary conditions can cause nerve damage.
• Treatable causes. Diabetes and prediabetes, vitamin deficiency, alcohol use and certain medications are causes of nerve damage that can often be reversed with lifestyle changes.
• Idiopathic causes. In about 1/3 of people with neuropathy, no known cause can be found, even with medical testing. 

Finding the Cause 

A neurologist’s job is to identify the cause of the tingling in your hands and feet. They’ll work to confirm that it’s related to nerve damage or if it involves the spinal cord or brain. That detective work begins with understanding your symptoms and health history. A neurologist may ask you:

• When your symptoms began and whether they started suddenly or gradually
• Whether the tingling in your hands and feet has spread or gotten worse  
• What sensations you feel (tingling, numbness, burning, pain or skin changes)
• If you’ve noticed muscle weakness or balance problems
• If you have a history of prediabetes or diabetes
• If you have other medical conditions, including autoimmune disorders
• If there’s a family history of neuropathy
• Whether you drink alcohol (and if yes, how much and how often)
• If you’ve had changes in bowel or bladder function
• If you’ve had changes in blood pressure
• If you’ve had any skin changes or lost hair on your arms or legs
• List of medications and supplements you are currently taking

In addition to a complete medical history, a neurologist may order tests, such as:

• Bloodwork to test for vitamin deficiencies, liver/kidney function, blood sugar levels, bone marrow disorders and other conditions
• Electromyogram and nerve conduction study (EMG/NCS) to evaluate the health of your muscles and nerves
• Genetic testing to check for hereditary causes
• Nerve biopsy, which is a procedure to remove part of the nerve to check for damage

Treatments for Tingling in Hands and Feet

Treatment options vary depending on the cause. “If we can identify the cause, we will treat the underlying condition or prescribe lifestyle changes to address it,” Neelakantan says. “But if we cannot identify the cause, then we can treat the symptoms with medications that calm the pain, numbness and tingling.”

If you’re having balance issues or muscle weakness, your neurologist may also order physical therapy.

When to See a Doctor About Tingling

Tingling or numbness in your fingers and toes can be brought on by sitting awkwardly, and the temporary sensation will vanish quickly. However, tingling in your hands and feet can also signal a bigger health problem. If the tingling becomes more frequent or is accompanied by a loss of balance or muscle strength, dizziness, light-headedness or bowel or bladder control problems, schedule an appointment with a doctor. You can start with your primary care doctor for initial testing, and if more testing is needed, you may need a referral to a neurologist.

The key, Neelakantan says, is to get a diagnosis as soon as possible.

“Some of these neuropathies are not reversible, but with the right workup and the right treatment, many of them are reversible if they’re caught in time,” he says. “So, time is of the essence, and getting the right help is important.”