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Paresthesia and Physical Sensations of MS

Posted on May 27, 2021
Medically reviewed by
Joseph V. Campellone, M.D.
Article written by
Ryan Chiu, M.D.

Multiple sclerosis (MS) has an array of common symptoms, including weakness, numbness, vision problems, and urinary and bowel problems. Some people with the condition experience paresthesias — abnormal sensations like buzzing, burning, numbness, and tingling — which can be especially uncomfortable and frustrating. In fact, nearly 30,000 MyMSTeam members report numbness as a symptom of MS.

If you are living with MS and experience paresthesia, you are not alone. Nearly 8 out of every 10 people with MS experience some type of paresthesia. Many report these sensations as their first symptom or an early one. Here, we will explain the causes of abnormal sensations, what forms they take, and available treatments.

Causes of Paresthesia in MS

Abnormal sensations in MS can be caused by dysfunction or nerve damage in the central nervous system (CNS), which includes the brain, spinal cord, and optic nerve. MS is an autoimmune disease that attacks sections of the CNS. These can cause lesions — scar tissues — that most often appear during flares (also called MS attacks or exacerbations).

Sections of the brain and spinal cord contain nerve fibers as well as nerve cells called neurons. They control sensation, movement, and bowel and bladder function, among other things. Normally, when a person feels sensations such as touch, pain, pressure, heat, or cold, signals are relayed to their brain in a split second. The signals travel via neurons from the nerve endings on the 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 myelin — the insulation surrounding nerve cells — can result in sensation disturbances such as numbness or tingling.

Common Sensory Patterns in MS

The most common type of MS is relapsing-remitting MS (RRMS). People with RRMS would mostly notice numbness and tingling (along with other symptoms) during flare-ups. However, paresthesias can also happen independently of a relapse, and the symptoms may be constant or may come and go. The sensations may occur randomly, but they’re common in the hands and feet as well as the arms and legs.

Although paresthesias can generally be described as numbness, tingling, or burning, certain symptom patterns are commonly seen in MS.

Lhermitte’s Sign

Lhermitte’s sign can occur when MS affects a part of the spinal cord in your neck. People with Lhermitte’s sign usually report feeling an electric-shock-like sensation, starting from the neck and radiating down their back — especially when bending their neck forward.

Uhthoff’s Phenomenon

People living with MS also commonly report worsening symptoms and sensations when they’re exposed to hot water or experience overheating from exercise, for example. This is called Uhthoff’s phenomenon, and it occurs in 6 to 8 out of every 10 people with MS.

Treating and Managing Paresthesias

Being able to properly feel is important for moving around and performing many everyday activities. For example, writing can be difficult when you have painful burning sensations in your hands. Having constant, uncomfortable sensations in the legs can result in difficulty walking. For these reasons, taking steps to avoid and treat abnormal sensations may be a priority.

For people with RRMS, these symptoms may go away at the end of a flare. Medications like steroids can speed up the recovery from flares. If your symptoms stick around, other strategies may help you live more comfortably with paresthesias.

Physical Therapy

Exercise therapy has been found to be helpful for many people living with MS. However, its potential benefits should be weighed against the risks of overheating with intense workouts, due to the link between MS symptoms and heat.

Physical therapists and other health care professionals are trained to help you work through exercise regimens designed around your specific symptoms and wellness goals.

Assistive Devices

If your symptoms are affecting your comfort and mobility, an assistive device — such as a cane, walker, or wearable leg or ankle braces — may help. Using these devices is often especially effective if you have other leg symptoms, such as muscle weakness, spasticity, or contractures.

Along those lines, if you’re having walking trouble, be mindful that stairs and rugs may become unexpected risks. Consider avoiding them while your symptoms persist.

Avoiding Heat

Avoiding activities that can cause overheating, like spending too much time in the sun or in hot baths, may also help reduce the severity of your sensory symptoms.

Medications

The first-line drug treatments for tingling and numbness related to MS flares are typically the same as those for general MS relapses — usually steroids.

Some drugs that generally treat seizures are also approved by the U.S. Food and Drug Administration (FDA) for treating symptoms of neuropathy (nerve pain leading to tingling and burning sensations). These medications include Neurontin (gabapentin) and Lyrica (pregabalin). Some antidepressant drugs, such as Elavil (amitriptyline), may also help with nerve pain.

Be sure to talk to your doctor about these options, as each of these drugs can have side effects that may differ from person to person. Discussing your symptoms with your doctor also can help them figure out whether or not your sensations are due to MS. If you haven’t been diagnosed with MS but you’re experiencing paresthesias, your doctor may order additional imaging, blood tests, or a spinal tap (lumbar puncture) to determine if MS is the cause.

Talk With Others Who Understand

MyMSTeam is the social network for people with multiple sclerosis and their loved ones. On MyMSTeam, more than 168,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.

Are you living with paresthesia and physical sensations in MS? What tips do you have for others? Share your thoughts in the comments below, or start a conversation by posting on MyMSTeam.

All updates must be accompanied by text or a picture.
Joseph V. Campellone, M.D. is board-certified in neurology, neuromuscular disease, and electrodiagnostic medicine. Review provided by VeriMed Healthcare Network. Learn more about him here.
Ryan Chiu, M.D. obtained his medical degree from the University of Illinois College of Medicine in 2021. Learn more about him here.

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