Condition
Numbness, Tingling and Shooting Pain
Numbness, tingling and shooting pain are symptoms, not a diagnosis.
- Seen at
- All three offices
- Typical wait
- Within the same week
- Treated with
- 3 procedures
In short
What numbness & tingling actually is.
Numbness, Tingling and Shooting Pain
Numbness, tingling and shooting pain are symptoms, not a diagnosis. The same dead hand or burning foot can come from a nerve root pinched in the neck or low back, a single nerve trapped at the wrist, elbow or ankle, a generalized peripheral neuropathy, or rarely a problem in the spinal cord or brain. EMG and nerve conduction testing is what tells them apart, because it measures whether a nerve is actually working and where along its path it stops working. Treating the wrong source is the most common reason these symptoms drag on for years.
Symptoms
How it shows up.
If several of these sound like your week, it is worth having the source looked at properly.
- Pins and needles in the hands or feet that used to come and go and now stay
- A hand or foot that feels dead, as though a thick glove or sock is in the way
- Electric shocks that shoot from the neck into the arm, or from the low back down the leg
- Burning in both feet at night that has you kicking the covers off
- Dropping things, or a grip that gives out without warning
- Skin that feels numb and hurts to touch at the same time
- Catching a toe on the carpet because you cannot feel the floor properly
What causes it
- A compressed nerve root in the neck or low back from a disc herniation or from arthritis narrowing the opening the nerve exits through
- A single nerve trapped at a tight spot: the median nerve at the wrist, the ulnar nerve at the elbow, the peroneal nerve at the knee or the tibial nerve at the ankle
- Peripheral neuropathy from diabetes, prediabetes, B12 deficiency, thyroid disease, alcohol or chemotherapy
- Injury to a nerve from trauma, a fracture, surgery or prolonged pressure
- Reduced circulation, which produces numbness along with cramping in the calves after walking a set distance
- Less commonly a cause in the spinal cord or brain, which changes the urgency entirely
When to act
Stop waiting when this happens.
Do not sit on these
Any one of the following is a reason to be seen rather than to wait it out.
- Numbness has become constant instead of coming and going, or has lasted more than a few weeks
- You have new weakness: a foot that slaps the ground, a grip that fails, a wrist that drops
- The numbness is climbing upward from the toes or fingers toward the knees or elbows
- Numbness in the groin or inner thighs, or any change in bladder or bowel control, which needs same day emergency care
- Symptoms came on suddenly, involve one whole side, or arrive with slurred speech, facial droop or vision loss, which is a stroke until proven otherwise and means calling 911
Diagnosis
Finding the actual source.
A diagnosis is not a guess from an image. It comes from the exam, the history and, where nerves are involved, electrodiagnostic testing.
- Mapping exactly where the numbness sits, finger by finger and toe by toe, because each nerve and each nerve root covers a territory with defined borders
- Asking what brings it on, since numbness that appears with the neck extended points somewhere different than numbness that appears after walking a block
- A neurological exam of strength, reflexes and sensation in both arms and both legs, compared side to side
- Nerve conduction studies that measure speed and signal strength along each nerve, which localize a trapped nerve to the exact segment where the signal slows
- EMG of selected muscles, which shows whether the problem sits at the nerve root in the spine or further out in the limb, a distinction no scan can make
- MRI of the neck or low back when the electrical testing points to a nerve root, ordered to confirm the level rather than to look around
Nerve testing happens here, not elsewhere
EMG and nerve conduction studies are done in the office and read by Dr. Sheikh the same day, rather than sent out and waited on.
Treatment
How numbness & tingling is treated.
Ordered from the most common first step to the options reserved for pain that has not responded.
15–30 minEpidural Steroid InjectionAn epidural steroid injection puts anti-inflammatory medication into the epidural space, the area just outsid…Read more →
15–45 minNerve BlockA nerve block is an injection of local anesthetic, often with a steroid, placed next to a specific nerve or c…Read more →
30–45 minSpinal Cord StimulationSpinal cord stimulation uses mild electrical pulses delivered through thin wires placed near the spinal cord…Read more →Questions
Numbness, Tingling and Shooting Pain, answered.
Why do I need an EMG if my MRI was normal?
The two tests answer different questions. An MRI shows what structures look like. Nerve conduction studies and EMG show whether a nerve is conducting and where it stops conducting. A trapped nerve at the wrist, elbow or ankle does not appear on a spine MRI at all, and a normal MRI never rules out nerve damage.
Can numbness in my hand come from my neck?
Yes, and it is one of the most common mix ups. A compressed C6 or C7 nerve root produces numbness in the same fingers as carpal tunnel syndrome. Some people have both at once. Nerve testing of the whole arm in a single session is the only reliable way to sort out which one, or whether it is both.
Is numbness a sign of something serious?
Usually not, but some patterns are. Numbness in the groin or inner thighs, loss of bladder or bowel control, weakness that is getting worse by the day, or numbness that arrives suddenly on one whole side all need emergency assessment. Numbness that has been slowly creeping up from the toes over months needs testing, not an ambulance.
What does nerve testing actually feel like?
The nerve conduction portion uses surface electrodes and brief electrical pulses that feel like a tap or a quick tingle. The EMG portion uses a very thin needle in a few selected muscles, which feels like a brief pinch or a cramp. It runs thirty to sixty minutes and you return to normal activity straight afterward.
Will the numbness go away?
It depends entirely on the source and how long it has been there. Numbness from a compressed nerve often improves substantially once the pressure is relieved. Numbness from long standing nerve damage may not fully return even after the cause is treated, which is the practical argument for testing sooner rather than later.
Get a real diagnosis for numbness & tingling.
Three New Jersey offices, most insurance accepted, and a real opening on the calendar.