Numbness and Tingling as a Symptom of Multiple Sclerosis

Parasthesia Can Affect Quality of Life

 

Pretty much all of us with multiple sclerosis (MS) have experienced paresthesia, the special form of numbness and tingling that accompanies MS. 

I understand intellectually what the medical writers and physicians mean when they refer to MS-related numbness and tingling as “only an annoyance,” “not disabling,” or a “benign” symptom.  However, it is language like this that informs me that the writer has probably never experienced this symptom.  Holding nothing against these people who are trying to help us, I’ll say that for myself, the itching, burning, and tingling was a minor form of physical and emotional torture.  The time when I felt the most alienated from my neurologist was when he responded to my question concerning how long this would last and what could I do to make it stop with a smile and a shrug. 

Numbness and tingling were the symptoms that led to my MS diagnosis.  It was scary and weird and I was convinced it was going to last forever.  It interfered with my walking, but even more than that, it caused constant psychological distress because it was always there.  Before I was diagnosed, it had me worried about all of the things it could be.  After I was diagnosed, it reminded me that one of my worst fears had been confirmed.

 

What Does It Feel Like?

Most commonly referred to as “numbness” or “tingling,” this is one of the MS symptoms that most people seek help for, as it is so common and it is clear that it is a neurological origins (as opposed to depression, constipation or fatigue).  It feels like:

·       Numbness

·       Pins and needles

·       Burning

·       Severe itchiness

·       Tingling, buzzing, vibrating sensations

 

How Common Is It?

Sensory symptoms are the most common symptom of MS, with up to 90% of people with MS reporting some form of numbness and tingling. 

 

What Causes It?

Paresthesias in MS are caused by lesions on the brain or spinal cord.  They can be as a result of touch (where the sensation is much more intense than a normal touch would cause).  They can also just occur spontaneously. 

Often, this numbness and tingling sensation occurs as part of a pseudoexacerbation, a temporary increase in symptoms caused by an external factor.  Usually this is a result of MS-related heat intolerance or as a result of MS fatigue.  If this is the case, the sensation should go away or greatly lessen in intensity once you are cool and/or rested. 

 

How Severe Can It Get?

It can occur everywhere in the body, presenting the following problems:

 

• Feet, causing problems walking because of pain, sensory ataxia, and interference with proprioception
• Hands, causing problems with writing, fine motor movements, holding things
• Genitalia, causing sexual dysfuncti
• Tongue, causing problems speaking, such as dysarthria, or detecting temperature of food

 

Additional Points/Information

Usual Pattern: The sensation usually appears in the hands and/or feet, then moves progressively closer to the core up the arms and legs, although it can appear anywhere. 

Will It Go Away? If it happens as part of a MS relapse, it may or may not resolve completely.  It is estimated that 42% of relapses result in residual symptoms, and paresthesia is one that seems to stick around.  However, if your doctor uses high-dose corticosteroids (Solu-Medrol) to reduce your relapse duration and severity, these may bring lasting relief from the numbness and tingling, as well. 

Benign? I do not like this word, as it seems to diminish the actual experience of this fairly horrible symptom.  However, what this really means is that paresthesia usually does not cause significant disability, does not indicate that the disease is getting worse and is not related to your degree of disability.  In fact, it was found that people experiencing pain or sensory symptoms performed better on movement and coordination tests. 

Unpredictable: Paresthesia can be transient (lasting for just a little while) or last for a long time.  The numbness and tingling can vary in intensity and can come at different times of the day.  It can feel like waves of tingling or steady throbbing.  In other words, everyone has his or her own special form of paresthesia. 

Can Interfere with Sleep: Paresthesias tend to be worse at night.  Make sure that the temperature in your bedroom is cool, which may help.  If the numbness and tingling significantly disturbs your sleep, you may need to talk to your doctor about a sleep aid or specific treatment for the paresthesia. 

Allodynia: This is a particular type of sensory symptom that is in result to a stimulus, such as a person’s touch or even clothing or bed linens touching their skin.  It is stimulus-dependent and only lasts as long as the stimulus is present.  Allodynia is usually a short-term problem. 

My Experience

I was walking to my car in the parking garage on a pretty hot day.  All of the sudden, I felt waves of tingling and itching starting at my feet and going about halfway up my calves, and then back down.  I reached my car and drove home carefully, having to talk myself through the experience, assuring myself that my foot was on the pedal, even though I couldn’t feel it because I was so distracted by the feeling in my feet.  Eventually, these “waves” settled down into a pretty disturbing tingling feeling, like ants were crawling all over my lower legs and occasionally biting me.  This led me to the neurologist’s office.  The rest, as they say, is history.

These days, I do not have this symptom constantly.  It comes on with a vengeance if I exert myself too much or get too hot.  Even walking on the treadmill at a moderate pace brings on the tingling sensation.  I have learned to ignore it when I am intentionally exerting myself during exercise.  However, it is an excellent barometer when I am outside and the temperature is rising – it informs me that I better get to a cooler place or much worse symptoms are on their way.

_Sources:

_{Randall T.  Shapiro.  Managing the Symptoms of Multiple Sclerosis (5th ed.).  New York: Demos Medical Publishing, 2007.} 

_{Rae-Grant AD, Eckert NJ, Bartz S, Reed JF.  Sensory symptoms of multiple sclerosis: a hidden reservoir of morbidity.  Mult Scler.  1999 Jun;5(3):179-83.} 

 

 

By Julie Stachowiak, Ph.D., About.com

 

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