You know that feeling when you sleep on your arm in a weird position and a tingling sensation wakes you up? What happens if that feeling lasts for days or even weeks at a time? Getting rid of the unpleasant discomfort is probably your top priority, but you should also check in with your GP, because you could be experiencing the signs and symptoms of multiple sclerosis.
Multiple sclerosis (MS) is a chronic, progressive, autoimmune, neurological disorder, in which your own immune system attacks the healthy tissue in the central nervous system— aka your brain and spinal cord. 'It specifically targets the myelin, which is a kind of insulating sheath that goes around the nerves in the central nervous system,' says Dr Tyler Kaplan, a neurologist at Rush University Medical Center. The attack on the myelin then causes lesions to develop in the body, which ultimately leads to the commonly known tingling sensation and muscle weakness caused by MS.
About one million adults in the United States are affected by MS, and it most commonly presents in people between the ages of 20 and 50, says Dr. Kaplan. It’s more common in women, and about 80 percent of people with MS have a relapsing-remitting disease course. This means that neurological symptoms attack, or “relapse,” over a period of time, before partially or completely improving, he explains.
Relapsing-remitting MS is the most common of the four known types of the disease, however 15 percent of people have primary progressive MS, in which their symptoms slowly and gradually worsen without any periods of relapse or remission.
But hold on a sec! Let’s clear the air. Just because you’ve experienced a tingling sensation before does not mean you have MS, stresses Dr. Kaplan. 'A lot of different things can cause damage to the nerves in your hands and feet, and cause numbness, tingling, and burning sensations,' he explains.
MS is a complex disease that is much more than a tingling sensation, so don’t panic every time you feel numbness or discomfort in your limbs. Consider this a mini lesson in MS and read on to know what the tingling really feels like and how you should cope.
What causes MS tingling?
Simply put, MS tingling is caused by nerve pain due to damage of the nerves. When the protective myelin gets damaged, the nerve becomes exposed, resulting in sensory changes such as numbness, tingling, and burning, says Dr. Kaplan. The gradual deterioration of the central nervous system then disrupts transmissions between the brain, spinal cord, and other areas of the body.
The tingling is usually caused by damage to the sensory nerves of the spinal cord, damage within the cerebral cortex (outer surface) of the brain, or damage within the thalamus (brainstem), says Dr. Kaplan. 'MS tingling can be due to damage to the nerves really anywhere in the central nervous system, and it’s not necessarily due to one particular area.'
So, what does it mean if you feel tingling? With MS, people can have chronic tingling and numbness related to underlying nerve damage, or as part of flares or relapses when people develop new symptoms, explains Dr. Kaplan.
'In the MS world, symptoms need to be present for 24 hours before it’s considered a true flare of MS,' he adds. In other words, if you have numbness or tingling that lasts for a few minutes to an hour, it cannot be directly correlated to MS.
Any new symptoms of numbness or tingling that persist for more than 24 hours is a red flag that something abnormal is happening in the body.
What does MS tingling really feel like?
Symptoms vary depending on the individual, but the tingling is usually an unpleasant feeling mimicking needles or an electrical sensation, and can sometimes also cause itchiness, burning, or a crawling sensation on the skin. 'The most common thing I’m told by patients is that it’s similar to when your hand or arm falls asleep,' says Dr. Kaplan. And while the tingling is not necessarily painful, it can last for days ultimately causing weakness in the affected area.
It’s also key to note that tingling can happen anywhere in the body, but it’s often localiSed to a specific spot. 'It really depends on where a lesion develops, but most symptoms are isolated to a discrete area,' explains Dr. Kaplan. For example, you may feel the sensation on the right side of your face, or your left arm. 'MS doesn’t cause diffuse or generalised tingling or numbness,' he adds. “If someone feels tingly all over their body, that is less likely to be related to MS.'
Many people also use descriptions of numbness and tingling interchangeably, but they are not the same thing. Tingling often refers to a prickly sensation, while numbness is associated with the loss or absence of sensation. 'They do tend to go together, but you can certainly have one without the other,' adds Dr. Kaplan.
What else can cause tingling?
Okay, now let’s really clear the air. Not all tingling in the body is related to MS! There are multiple other common alternatives that could cause the pins and needles sensation.
Peripheral neuropathy causes tingling and is a condition that affects the peripheral nervous system (aka everything outside of the brain and spinal cord), says Dr. Kaplan. 'There are always exceptions, but in general the most common cause of peripheral neuropathy is diabetes,' he adds. 'If someone has a known history of diabetes, they should follow up with their doctor, or talk to a doctor about being screened for diabetes if you have high risk factors such as obesity or a family history of diabetes.'
Other culprits of tingling in the body are thyroid dysfunction such as hypothyroidism, and certain vitamin deficiencies like B1, B6, and B12, notes Dr. Kaplan. 'These are all things that can be screened by a primary care doctor, because things like diabetes and hypothyroidism are a lot more common than MS and are both treatable disorders.'
Tingling can also be caused by a herniated disk, radiation therapy, shingles, bug bites, and even just sitting or standing in the same position for a long time. Remember that tingling associated with MS typically sustains for more than 24 hours.
What are some other early warning signs?
Tingling is not the only signal of MS. Fatigue, blurred vision, tremors, short term memory loss, and muscle stiffness are also common warning signs to look out for.
In addition, other neurological symptoms such as increased or jumpy reflexes, motor weakness, vertigo or dizziness, and bladder problems such as frequent and urgent urination are also common traits of MS, says Dr. Kaplan. 'If you have numbness or tingling along with any of those kinds of symptoms, that is more concerning that something is happening within the brain or the top of the spinal cord.'
What should you do if you feel tingling?
If you feel weak and have a sudden loss of sensation or paralysis on one side of the body in addition to tingling, seek medical care immediately and call 911, says Dr. Kaplan. 'That is more concerning for something like a stroke, especially if you are older and have certain risk factors like high blood pressure, hypertension, high cholesterol, or a smoking history.'
But if tingling symptoms come on over hours or days, then you want to schedule an appointment with your primary care doctor where they will evaluate if you need an MRI or additional neurological testing, says Dr. Kaplan. 'Sometimes it can take a while to get into an outpatient neurologist, and the sooner you can be seen by a medical professional, and at least evaluated, the better, especially if symptoms are over the course of days or weeks.'
If diagnosed with MS, there are currently 23 FDA approved medications to help treat symptoms and prevent future damage in the brain. 'There are pills [you can swallow], IV medication you get at an infusion center, and injectable medications you give yourself at home,' says Dr. Kaplan.
While MS is not curable since it’s a chronic disease and the damage to the nervous system cannot be reversed, it is very much manageable. 'The earlier you get treated, the better outcomes we see in long term disability,' stresses Dr. Kaplan. So, even if you don’t have intense symptoms that are currently disabling, book a visit with your doc ASAP to figure out the best course of action.
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