Feelings of numbness and tingling are common symptoms of multiple sclerosis (MS). Not only can these feelings be uncomfortable and frustrating, but they can have a dramatic impact on one’s quality of life. In fact, more than 29,000 MyMSTeam members report numbness as a symptom of MS.
One MyMSTeam member wrote that tingling was one of their first MS symptoms: “I had a tingling in my thumb. Carpal tunnel syndrome from typing so much, the doc said. But then it spread up my arm and the real ‘fun’ started.”
Such experiences can be stressful and frightening. Unfortunately, they are very common among people living with MS, affecting 8 out of every 10. This article may help by providing an understanding of the causes of abnormal sensations, their effects, and available treatments.
Abnormal sensations, such as numbness and tingling, can be further divided into several categories.
These are often described as “pins-and-needles,” “buzzing,” or “crawling” sensations. One MyMSTeam member stated, “My arm went numb and tingly, and three days later the side of my face went the same way.”
These sensations might be described as painful “burning,” “prickling,” or “stabbing,” and may also include higher sensitivity to pain. Another member of the MyMSTeam community described how “walking in front of the AC hurts my skin, even a sheet rubbing against it means 30 to 45 minutes of more pain.”
This refers to complete numbness by itself. This symptom is rarely seen in MS and is much more likely due to other conditions.
All of these abnormal sensations can be caused by dysfunction or damage, such as brain lesions, to the central nervous system (the brain, spinal cord, and optic nerve). They also can result from damage to nerves outside of the brain and spinal cord (the peripheral nervous system), which are almost always caused by conditions that aren’t MS (such as carpal tunnel syndrome).
Both the central and peripheral nervous systems are made up of nerve cells (neurons) and nerve fibers. Normally, sensations — such as touch, pain, pressure, heat, and cold — get relayed to the brain in a split second’s time. They travel via neurons from the nerve endings on your skin, up through individual nerves, into the spinal cord, and then up into the brain. The brain then triggers a reaction to the sensations. Anywhere along this pathway, nerve damage or destruction of the insulation around the nerve cells, called myelin, can result in sensation disturbances such as numbness or tingling.
MS is an autoimmune disease that attacks sections of your central nervous system, most often in flares (also called MS attacks or exacerbations). In MS, the immune system does not discriminate between the parts of the brain or spine that control sensation versus movement, for example. Therefore, one way that neurologists know that MS is causing your paresthesias is if it happens at the same time and in the same pattern as other symptoms of MS.
Most cases of MS are what is called relapsing-remitting MS. People with this type of MS would notice their numbness and tingling, along with other symptoms, mostly during “attacks.” Each MS flare is unique in its symptoms in different parts of the body.
Facial numbness is also one of the first symptoms of MS. However, it is often misdiagnosed as Bell’s palsy, sudden facial muscle paralysis or weakness with an unknown cause. From 2.9 percent to 13.6 percent of people with MS that have experienced facial numbness.
“It's constant and hasn't gone away for the past four days or so,” shared one MyMSTeam member. “For two weeks, I have had numbness and tingling on different parts of my face,” another wrote. “First it was my right lower jaw, then the center of my face and right eye.”
Certain patterns of symptoms, along with abnormal sensations, are typically linked to MS. Lhermitte’s sign can also occur when MS affects a large cross-section of the spinal cord in your neck. People with Lhermitte’s sign usually report feeling an electric-bolt-like sensation traveling from the neck down their back, especially when bending their neck forward.
People living with MS also commonly report worsening symptoms when they’re exposed to hot water or experience overheating from, for example, exercise. This is called the Uhthoff’s phenomenon, and it occurs in 6 to 8 out of every 10 people with MS in some form.
On the other hand, there are some clues that numbness and tingling might not be signs of MS. MS does not directly affect the peripheral nerves — only the brain and spinal cord — so symptoms that point to these nerves may lead your doctor to consider other causes.
Individual nerves can become trapped by other matter, like fat, muscle, tendons, and ligaments. This is called entrapment neuropathy, with carpal tunnel syndrome being a well-known example. Entrapment neuropathy usually occurs in one isolated part of the body (e.g., the wrist in carpal tunnel) and gets worse with certain movements (e.g., typing).
Damage to the peripheral nerves can also result from viruses (e.g., Epstein-Barr virus or herpes virus), toxins, or abnormal vitamin or blood-sugar levels, which can damage nerve cells. The sugar buildup in the blood from diabetes, for example, can cause nerve damage. So, too, can a vitamin B12 deficiency, as nerves need the vitamin to stay healthy.
People affected by peripheral nerve damage can experience a “stocking and glove” pattern of tingling, feeling it symmetrically in both hands or feet, particularly at the tips. Research has also shown that vitamin D levels in the blood might relate not only to sensory symptoms, but to MS as a whole. Therefore, your health care provider might order blood tests to see if you have abnormal levels of any essential compounds.
Moving around and performing many everyday activities requires being able to feel with your hands and feet. This is the reason why numbness can be so difficult and frustrating for people living with MS, affecting their overall wellness. Arm numbness can make writing and getting dressed difficult or impossible. Numbness and tingling can also result in accidental injury. For example, numbness can make it difficult to distinguish dangerously hot water from cold. Numbness in the legs can affect your ability to walk around normally.
Experts have also found that people with vision problems in the early stages of MS often also have facial numbness. “One day, I woke up blind for about 20 minutes. I rushed to my doctor and he diagnosed me with retrobulbar optic neuritis and multiple sclerosis,” shared one MyMSTeam member. “I was in shock. I even went to two different eye doctors just to make sure this was correct.”
Severe facial numbness and tingling may also cause other problems when talking, eating, or chewing. “It gets difficult when my lips become more numb and my speech slurs a bit,” wrote one member. People may also accidentally bite their tongues or inside their mouths.
Many people with MS also report depression and anxiety. Therapy, acupuncture, mindfulness exercises, and meditation have all been shown to help with depression and anxiety — as well as numbness and tingling.
Here’s the good news: These symptoms usually go away at the end of a flare, and medications such as steroids can speed up the recovery process. For some people, however, this discomfort can last for a while longer after an MS attack. There are many strategies that can help you live more comfortably while having these symptoms.
MS symptoms and heat have been found to be linked. Therefore, it can be helpful to avoid activities that can cause overheating, like over-exercising or spending too much time in the sun. If you experience feelings of numbness or tingling in your legs, you may consider a device that can help with walking around, such as a cane, walker, or wearable leg or ankle braces.
Exercise therapy may also be helpful for many people living with MS. However, this should be weighed against the risks of overheating with intense workouts.
Medications used specifically for numbness and tingling symptoms often have other uses. Many drugs that treat seizures, for example, are approved for neuropathy by the U.S. Food and Drug Administration. These include gabapentin (Neurontin) and pregabalin (Lyrica). Some antidepressant drugs, such as amitriptyline (Elavil), may also help.
Tell your doctor about any numbness or tingling you are experiencing. They can help you determine whether or not these sensations are due to MS or other conditions. They also may order additional imaging or tests to help answer this question.
MyMSTeam is the social network for people with multiple sclerosis and their loved ones. On MyMSTeam, more than 185,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.
Are you living with numbness or tingling and MS? Have you found any treatments to be helpful? Share your experience in the comments below, or start a conversation by posting on MyMSTeam.