Numbness and Tingling in Multiple Sclerosis

Why It Happens, How It Affects You, and Ways to Cope

In This Article

Numbness and tingling are two of the most common symptoms of multiple sclerosis (MS). In fact, they were likely some of your first symptoms and may have been what led to your diagnosis. While numbness and tingling can be frightening, they're usually not as disabling as motor symptoms. It may also help to know that these symptoms don't necessarily mean that your MS is progressing—they can happen whether or not you're having a relapse.

How It Can Feel

Most people have experienced the sensation of an extremity "falling asleep." The sensation is similar in MS, except that it's chronic, it can last much longer, and it may occur in other places besides your arms, legs, hands, and feet.

Most commonly referred to as “numbness” or “tingling,” these are two of the most frequent MS symptoms for which people seek help. They're part of a group of sensory symptoms called paresthesias, abnormal sensations that cause discomfort but not pain.

Though numbness and tingling are most often the terms used to describe these sensations, other paresthesia characteristics can include:

  • Pins and needles
  • Burning
  • Tickling
  • Itching
  • Prickling
  • The affected area feeling cold
  • Difficulty using the affected area
  • Buzzing
  • Vibrating
  • Throbbing

When a sensation is painful, it's called a dysesthesia, another type of sensory symptom. An example is feeling like your feet are burning.

Some people with MS also experience another sensory symptom called allodynia, which is feeling pain when you're touched with things that don't normally cause pain, such as your clothes or a friendly stroke of your arm. Each person has his or her own individual pattern of sensory disturbances in MS that can include any of these symptoms.

Sensory symptoms can be transient (lasting for just a little while) or they can last for a long time. In addition, while some sensory symptoms cause only mild discomfort or are simply annoying, as in the case of paresthesias, others may be quite painful.

If your numbness and tingling are new, severe, and/or long-lasting, this may be a sign of an MS relapse. See your doctor to get a diagnosis.

Location and Effects

Numbness and tingling in MS can occur anywhere in your body, which may present a variety of problems depending on their location. For example, if your feet are affected, you may experience problems walking because you feel pain when you put pressure on your feet, your coordination and balance are impaired, and your proprioception, the ability to sense where you are, is off.

When your hands are affected, you may experience problems with writing, fine-motor movements, or holding things.

Sensory issues in the genitalia, especially numbness, can cause sexual dysfunction. Paresthesias of your tongue or face may make it difficult for you to speak, eat, drink, or to detect the temperature of your food.

Sensory disturbances, including numbness and tingling, tend to be worse at night and when you're hot. A good rule of thumb is to ensure your bedroom is cool, as this may help ease your symptoms. If numbness and tingling significantly disturb your sleep, you may need to talk to your doctor about a sleep aid or a specific treatment for the paresthesia. You can use our Doctor Discussion Guide below to help start that conversation.

Multiple Sclerosis Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Doctor Discussion Guide Woman

Causes

Sensory symptoms in MS are caused by lesions on your brain and/or spinal cord, which occur as a result of demyelination of the nerve fibers that carry sensory information from your body to your central nerve system (brain and spinal cord).

Often these sensory disturbances occur as part of a pseudo-exacerbation, a temporary increase in symptoms caused by an external factor. Usually, this is a result of MS-related heat intolerance or fatigue. If this is the case, the sensation should go away or at least greatly lessen in intensity once you're cool and/or rested.

Treatment

While there are no medications to treat numbness and tingling specifically, there are some options you can try that may help these symptoms.

Complementary and Alternative Medicine

Some people find relief from their sensory symptoms by using complementary and alternative medicine (CAM) approaches, such as:

  • Reflexology: With this therapeutic technique, a practitioner presses on certain points on your hands and feet to promote healing.
  • Acupuncture: This treatment involves pricking your skin with needles to relieve pain. Since acupuncture can stimulate your immune system (an undesirable outcome since MS is thought to be an autoimmune disease), talk to your doctor before you try this.
  • Biofeedback: Because it reduces your stress levels, biofeedback may help your numbness and tingling.
  • A new diet: It's possible that certain foods trigger your symptoms, though this is a controversial topic. For instance, the Best Bet Diet has helped some people. Work with a dietitian to strategically pinpoint the foods that exacerbate your symptoms and a design plan to minimize your intake of them.
  • Supplements: Low levels of vitamin B12, a deficiency that's more common in people with MS, could cause sensory symptoms. Look into getting your B12 level checked, just to be sure, and ask your doctor whether it's a good idea to take a supplement.

    Medications 

    There has been limited success in treating MS-related numbness and tingling with medication, so drugs are often considered a last resort. But if no other strategies are providing you with relief, ask your doctor if one of these medications might be an option worth trying:

    • Neurontin (gabapentin)
    • Elavil (amitriptyline)
    • Cymbalta (duloxetine)

    These medications, like all drugs, do have possible side effects. However, if your numbness/tingling is truly unbearable, it may be worth trying one.

    If your sensory symptom is new, much worse than before, or has lasted more than 24 hours, this may signal a relapse. In this case, your doctor will probably put you on a course of Solu-Medrol, after confirming a relapse with magnetic resonance imaging (MRI).

    Coping

    There are also some management techniques you can try that may reduce or even prevent numbness and tingling, as well as help you deal with them when they do occur.

    Relax

    Your sensory symptoms may get worse when you're stressed. In fact, just thinking about a stressful situation can be enough to ratchet up tingling in your feet.

    Try taking a break from your stress and relaxing. If you can find time to turn off that part of your brain that has you worried about finances, wondering how you're going to get everything done, or replaying an angry conversation, for example, your symptoms may back down a little.

    One strategy is doing a mini-meditation. This is not an in-depth meditation; it involves taking one or two minutes in the middle of a stressful period to close your eyes, take a few deep breaths, and focus your thoughts on your breathing.

    Alternatively, do something that you love for at least a couple of minutes. Listen to a podcast or your favorite song. Read a couple of pages in a fun novel. Have a cup of tea. Go for a walk around the block. Carving out a little time for self-care every day can help you manage your anxiety.

    Warm Up or Cool Down

    Sometimes your feet can get either very hot or very cold, especially at night, and these temperature extremes are often accompanied by a burning or tingling sensation.

    To warm up your feet, try a wrap that's filled with rice or beans that can be heated up in the microwave and put on any body part that's chilly. You can put one on your feet and one over your shoulders. You can also stick your feet in hot water. Wearing thick socks to bed helps too. 

    Cooling down burning feet is a little trickier. The solution can be something simple, like sticking your feet outside the sheets when you're in bed, standing on cool bathroom tiles, or putting a cold, wet washcloth on them. 

    Avoid Triggers

    Pay attention to what triggers your symptoms and try to avoid them in the future. For instance, if getting over-heated from exercise triggers your leg numbness, try walking in an air-conditioned gym instead of outdoors, or consider a cooling vest.

    Exercise

    A 2016 study looked at the impact of exercise on MS symptoms in 54 females. The participants were assigned to either a non-exercise group, a yoga group, or an aquatic activity group. The researchers found that participation in either yoga or aquatic activities three times a week for eight weeks had a positive impact on common MS symptoms, specifically depression, fatigue, and paresthesia.

    The researchers hypothesized that paresthesia symptoms may have indirectly improved due to decreased symptoms of depression rather than from the exercise itself, but suggest that exercise programs may be a good complementary addition to MS treatment programs.

    Be Cautious

    Make sure you're taking appropriate precautions when you feel numbness and tingling in areas of your body that could create safety issues. For instance, if you have facial numbness, be cautious when you're chewing food and drinking hot beverages so you don't bite the inside of your mouth or tongue or burn yourself.

    If you're feeling paresthesias in your hands or feet, be careful not to engage in any activity in which you might lose your grip or fall down and injure yourself. If possible, try to relax until the sensations pass.

    A Word From Verywell

    It's important to tell your doctor if your paresthesias are painful or bothersome to the point that they're affecting your functioning or quality of life. Be reassured, too, that while your numbness and tingling may be uncomfortable or distracting, they're not as worrisome to doctors as, for example, loss of vision, falling, or balance problems. Let your doctor know if these symptoms become severe, last for a long time, or are accompanied by other symptoms.

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    Article Sources

    • Birnbaum G. Multiple Sclerosis: Clinician’s Guide to Diagnosis and Treatment. 2nd ed. New York, NY: Oxford University Press; 2013.

    • International Association for the Study of Pain (IASP). IASP Terminology. Updated December 14, 2017. https://www.iasp-pain.org/Education/Content.aspx?ItemNumber=1698.

    • Multiple Sclerosis Trust. Altered Sensations. Updated July 2018. https://www.mstrust.org.uk/a-z/altered-sensations.

    • National Multiple Sclerosis Society. Numbness or Tingling. https://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms/Numbness.

    • Razazian N, Yavari Z, Farnia V, et al. Exercising Impacts on Fatigue, Depression, and Paresthesia in Female Patients with Multiple Sclerosis. Medicine and Science in Sports and Exercise. 2016;48(5):796–803. doi: 10.1249/MSS.0000000000000834.