Pins and needles in my right arm

Arm numbness can be a symptom of a wide variety of diseases, disorders or conditions that either restrict blood flow or cause injury to the nerves.

Temporary arm numbness can occur after prolonged pressure on a nerve or nerves, such as due to fine motor activities (drawing) or sleeping the wrong way on your arm.

Arm numbness can occur with moderate to serious orthopedic and circulatory conditions, as well as disorders and diseases that damage the nervous system. In some cases, numbness is a symptom of a serious or life-threatening condition that should be evaluated as soon as possible in an emergency setting.

Whether one or both arms are numb will help diagnose the underlying cause. Bilateral arm numbness is more likely to be caused by body-wide disorders including diabetes, multiple sclerosis, or pernicious anemia. Numbness in one arm can be due to a pinched nerve, broken bone, or stroke.

Circulatory causes of arm numbness

Arm numbness can be caused by lack of blood flow to the arm due to such conditions as:

• Arteriovenous malformation (tangled knot of arteries and veins)

• Buerger’s disease (acute inflammation and clotting of arteries and veins)

• Frostbite or extremely cold temperatures

• Peripheral artery disease (PAD, also called peripheral vascular disease, or PVD, which is a narrowing of arteries due to a buildup of fat and cholesterol on the artery walls, which limits blood flow to the extremities)

Orthopedic causes of arm numbness

Arm numbness may also occur because of moderate to serious orthopedic conditions that injure or damage the nerves including:

• Broken bone or a cast that is too tight

• Cervical spondylosis (degenerative disk disease in the neck)

• Herniated disk

• Neck or spinal cord injury

• Nerve entrapment or nerve pressure (such as from sleeping on your arm)

• Osteoporosis

Neurological causes of arm numbness

Arm numbness caused by nerve compression or damage may be due to such conditions as:

• Alcoholism

• Diabetic neuropathy (nerve damage due to high blood sugar levels associated with diabetes)

• Heavy metal poisoning such as lead poisoning

• Hypothyroidism (underactive thyroid)

• Multiple sclerosis (disease that affects the brain and spinal cord)

• Peripheral neuropathy (disorder of the peripheral nerves)

• Spinal cord injury or tumor

• Stroke

• Systemic lupus erythematosus (a disorder in which the body attacks its own healthy cells and tissues)

• Transverse myelitis (neurological disorder causing inflammation of the spinal cord)

• Vitamin B12 deficiency (as in pernicious anemia)

Questions for diagnosing the cause of arm numbness

To diagnose your condition, your doctor or licensed health care practitioner will most likely ask you several questions related to your arm numbness including:

• Where are you feeling numb?

• When did the numbness start?

• How long does the numbness last?

• Are there any activities that cause the numbness?

• Are you experiencing other sensations, such as pain, burning or itchiness?

• Do your arms, hands or fingers feel cold or warm?

What are the potential complications of arm numbness?

Any complications associated with arm numbness can be progressive and vary depending on the underlying cause. Because numbness can be due to serious diseases, failure to seek treatment can result in complications and permanent damage. It is important to contact your health care provider when you experience any kind of persistent numbness or other unusual symptoms. Once the underlying cause is diagnosed, it is important to follow the treatment plan outlined by your health care provider to reduce your risk of potential complications related to arm numbness, such as:

• Amputation

• Arm disability

• Inability to perform daily tasks

• Loss of strength

• Paralysis

• Permanent loss of sensation

• Permanent pain

• Poor quality of life

Explore Numbness & Tingling

Overview

Numbness and tingling? It may not be Carpal Tunnel Syndrome (CTS).

Although carpal tunnel syndrome is common, it is not the only cause of numbness, tingling, and pain in the forearm and hand. Most of the lay public and some of the medical community are not aware of other causes, so numbness, tingling and pain may be mistakenly thought to be coming from Carpal Tunnel Syndrome. These symptoms can be caused by many other conditions.

Local pressure on a nerve (“compression neuropathy”) causes numbness in distinct patterns that follow the area supplied by that nerve (see diagrams). Also, the muscles that are controlled by the compressed nerve may exhibit weakness, wasting, or twitching. The pressure may come from injury, thickened muscles, bands of connective tissue, enlarged blood vessels, ganglion cysts, or arthritic spurs. Ulnar nerve compression at the wrist causes numbness and tingling of the little finger, part of the ring finger, and the little finger side (ulnar side) of the palm. Ulnar nerve compression at the elbow causes not only the numbness noted above, but also numbness on the back of the ulnar side of the hand. Pressure on the radial nerve (see Figure 1) in the forearm or above the wrist can cause numbness over the back of the thumb, the index finger, and the web between these two digits. If the median nerve (see Figure 1) is compressed at or just below the elbow, numbness is felt not only in the same area as in CTS but also over the palm at the base of the thumb. Compression neuropathies may require surgery to release pressure on the nerve(s) to get relief.

Nerves in the hands and forearm have their roots in the neck. Pressure on nerves in the neck (C6-T1) can be caused by numerous conditions. Arthritis may cause bone spurs or narrowing of the spinal canal, causing pressure on nerves, or degenerating discs may press directly on the nerves at the spinal column or as they leave the spinal column and pass to the upper limbs. Diseases, infections, tumors, blood vessels abnormalities, and other conditions of the spinal cord itself, in the neck, can cause pressure on the cord, which may result in numbness, tingling, or aching in the arm, forearm or hand. Weakness and/or wasting of muscles supplied by that nerve may be found. Decreased reflexes in the arm and forearm may also result from pressure on certain specific nerves in the neck. The pattern or zone of the numbness is often very distinct for each nerve root affected.

Sometimes, a nerve may suffer from pressure at more than one area. For example, a nerve may be compressed in the neck, and then again further down the arm, for example at the wrist. This is called “double crush”. When a nerve suffers from pressure at one level, it may be more susceptible to problems from pressure at another level.

Numbness and tingling can be caused by diseases of the central nervous system. Multiple sclerosis, stroke, and other disorders of the brain and spinal cord may sometimes cause numbness in the forearm and hand.

Other diseases can affect the nerves in the upper limb, causing numbness, tingling, burning. If the symptoms are more diffuse, that is, in the hands and forearms (and in the legs and feet), the cause may be a condition called “peripheral neuropathy”. The pattern of numbness is not usually that of one nerve, but instead may be generalized, like the pattern of a glove. There may or may not be pain and the numbness is often constant. Diabetes, alcoholism, and old age are common known causes of neuropathy. Poisoning from metals and industrial compounds are also possible causes.

Certain medications, such as cancer treatment drugs, are known to cause numbness and tingling in the hands. Some of these cause temporary numbness that resolves after completion of the chemotherapy treatment. Others may cause permanent numbness. Nutritional deficiencies, such as vitamin B1 deficiency, may result in numbness and tingling.

The pattern and distribution of numbness, tingling, burning, dullness, and muscle changes help to determine if the source is pressure on a nerve at a particular level (e.g. neck, wrist, elbow), disease, medication, nutritional, or other conditions. Depending on the suspected cause, further testing, such as X-ray, MRI, nerve tests (such as EMG), or blood tests may be used to help confirm a diagnosis, and specific treatment recommendations can then be made.

Used with permission from American Society for Surgery of the Hand.

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