Numbness and tingling are common sensations for many people living with multiple sclerosis (MS), and these feelings can become a regular part of life. These are some of the most common symptoms of MS, and they can affect your quality of life in many ways. For some MyMSTeam members, these sensations are among their earliest symptoms. “I had tingling in my thumb,” wrote one member. “The doctor said it was carpal tunnel syndrome from typing so much. But then it spread up my arm, and the real ‘fun’ started.”

More than 32,000 members of MyMSTeam report numbness as a symptom of MS, and more than 26,000 report that they’ve experienced pain with MS. “Pins-and-needles” sensations like numbness and tingling are one type of neuropathic (nerve-related) pain that can happen with MS. This article will cover different causes of numb, tingling sensations and ways to find relief.

How MS Causes Numbness and Tingling

Paresthesias (abnormal sensations) such as numbness and tingling can be caused by brain lesions or other damage to the central nervous system (CNS). The CNS includes the brain, spinal cord, and optic nerve. Paresthesias can also be caused by damage to the peripheral nervous system — the nerves outside the CNS.

Both the central and peripheral nervous systems are made up of neurons (nerve cells) and nerve fibers. Normally, sensations — such as touch, pain, pressure, heat, and cold — are sent to the brain quickly. They travel via neurons from the nerve endings on the skin, up through individual nerves, and into the spinal cord and the brain. The brain then triggers a reaction to the sensations. Nerve damage anywhere in the nervous system can disrupt the messaging and result in neuropathic pain and other paresthesias.

MS attacks sections of the CNS, often during periods of worsening known as relapses or flare-ups. If your numbness and tingling start or get worse during flares, along with other symptoms of multiple sclerosis, your neurologist may consider it more likely they’re caused by MS damage to your nerves.

Types of Numbness and Tingling With MS

Numb or tingling sensations with MS can occur anywhere in the body, and they can range from mild numbness or sensitivity to burning or complete numbness. Here are a few examples of ways MS can cause numbness and tingling in different parts of the body.

Facial Numbness With MS

Facial numbness may be one of the first symptoms of MS. Between 2.9 percent and 13.6 percent of people with MS have experienced facial numbness. Some studies suggest that facial numbness in MS may be due to lesions on the trigeminal nerve. This nerve controls feeling in the face and helps with chewing and tongue movement.

“It’s constant and hasn’t gone away for the past four days or so,” shared one MyMSTeam member of the face numbness they experienced. “For two weeks, I have had numbness and tingling on different parts of my face,” another wrote. “First it was my right lower jaw, then the center of my face and right eye.”

Lhermitte’s Sign

Certain patterns of symptoms, along with abnormal sensations, are typically linked to MS. Lhermitte’s sign can occur when MS affects a large cross-section of the spinal cord in the neck. People with Lhermitte’s sign usually feel an electric shock-like sensation traveling from the neck down their back, especially when bending their neck forward.

Symptoms Triggered by Heat

People living with MS also commonly report worsening symptoms when they’re exposed to hot water or experience overheating from, for example, exercise. This is called Uhthoff’s phenomenon, and it affects about 60 percent to 80 percent of people with MS.

Other Causes of Numbness and Tingling

On the other hand, there are some clues that numbness and tingling may not be signs of MS. MS attacks the CNS, not the peripheral nerves. If symptoms or test results point to damage of peripheral nerves as being responsible for your symptoms, your doctor may consider other health conditions beyond MS as the possible cause.

Entrapment Neuropathy

Individual nerves can become trapped by other tissue, like fat, muscle, tendons, and ligaments. This is called entrapment neuropathy. Entrapment neuropathy usually develops in one isolated part of the body (like the wrist in carpal tunnel) and gets worse with certain movements, such as typing. Some kinds of entrapment neuropathies may be more common in people with MS due to some risk factors (for example, the use of mobility aids).

Piriformis Syndrome

Some people with MS may also experience piriformis syndrome, which can cause numbness and tingling along the back of the legs. Piriformis syndrome may develop as a result of injury to the piriformis muscle from falls or, over time, due to poor posture. The piriformis muscle is a small, flat muscle located deep in the buttock, running from the lower spine to the top of the thigh bone. It helps rotate the hip and leg outward. An article in Spine-health stated that piriformis syndrome is more common in women, as is MS. Physical inactivity is also a risk factor for piriformis syndrome. People with MS may be less physically active due to fatigue, which tends to get worse with exercise.

Damage to Peripheral Nerves

Peripheral nerve damage can also be caused by viruses, toxins, low vitamin levels, and high blood sugar. For example, the sugar buildup from diabetes can damage nerves, and a lack of vitamin B12 can also cause problems because nerves need this vitamin to stay healthy. Your doctor can help determine if you need any tests to find out what might be causing your symptoms.

Living With Numbness and Tingling

MyMSTeam members often discuss how numbness and tingling feel and affect them, as well as how long it lasts. Moving around and performing many everyday activities requires being able to feel with your hands and feet, making numbness a difficult and frustrating symptom for people living with MS. Arm and hand numbness can make writing and getting dressed difficult or impossible. Numbness and tingling can also result in accidental injury. “With numbness in my fingers, I need to be careful because I’ve burnt and cut my fingers, and I don’t feel it,” shared one MyMSTeam member.

Numbness in the legs or feet can affect your ability to walk around normally or drive safely. “I can’t walk properly,” said a member. “It feels like I’m drunk.” “Another related their decision to stop driving due to these symptoms: “Gave up driving several years ago, it just wasn’t safe. My legs went completely numb on the way to pick up my daughter at a car rental.”

Severe facial numbness and tingling may also cause other problems when talking, eating, or chewing. “It gets difficult when my lips become more numb and my speech slurs a bit,” wrote one member. People may also accidentally bite their tongues or inside their mouths. Other times, symptoms may just be strange. “My left nostril is tingling and numb,” said a member. “Not my whole nose. Not the tip of my nose. Just my left nostril. MS is weird.”

No matter the affected area of your body, there are several steps you can take to improve numbness and tingling symptoms. You may have to try more than one to find what works for you.

Tips for Relief From Numbness and Tingling

Here’s the good news: If they’re caused by MS, these symptoms may get better or go away at the end of a flare. A short course of corticosteroids (steroids) can speed up the recovery process.

For some people, however, numbness and pain linger after an MS attack. There are several things you can try to help you live more comfortably while having these symptoms.

Avoid Overheating

Heat can often trigger or worsen MS symptoms. Therefore, it’s important to avoid activities that can cause overheating, like overexercising or spending too much time in the sun.

Ask About Medications for Nerve Pain

Some antiepileptic drugs (drugs that treat seizures) are also approved for neuropathy by the U.S. Food and Drug Administration (FDA). These include gabapentin (Neurontin) and pregabalin (Lyrica). Some antidepressant drugs, such as amitriptyline (Elavil), may also help. Ask your neurologist whether any of these treatment options might be useful to help manage your symptoms.

Try Ice

Several MyMSTeam members have reported that cooling down the body part affected by numbness and tingling soothed these symptoms.” Ice packs on some extremities,” recommended one member with numbness. “And I’ve found that cold baths have been very helpful.” Another member who experiences tingling in their fingers wrote, “I usually ice my hands or hold on to an ice-cold drink.”

Get a Massage

Massage or other types of pressure is another popular tip from members with numbness. “I would suggest a gentle hand massage,” said one member in response to someone asking for help with hand numbness. “And squeeze balls that relieve the numbness.” In a similar vein, another member suggested “some kneading of the soft tissue may improve circulation and relieve the muscle tightness and tingling.”

Consider Gentle Exercise

While it’s important to use caution and avoid overheating, many members have said that tingling goes away with movement. Water exercise is mentioned often. “Exercise in the pool helps a lot,” wrote one MyMSTeam member. Another who was noticing improvement in their numbness said, “I think exercising more regularly now is helping.”

Talk to Your Doctor

Tell your neurology team about any new symptoms of numbness or tingling. They can help you determine whether these sensory symptoms are due to MS or other conditions. They may also order imaging or blood tests to help figure out the cause of your symptoms.

Disease-modifying therapies (DMTs) are proven to help reduce the rate of MS relapses and slow the progression of the condition. There are many DMTs available, and they may be taken daily as pills, given as daily or weekly shots at home, or infused intravenously (into a vein) less often at a clinic. If you’re still having MS flares despite taking a DMT, your doctor may recommend switching to a more effective one.

Find Others Who Understand

MyMSTeam is the social network for people with multiple sclerosis and their loved ones. On MyMSTeam, more than 215,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.

Are you living with numbness or tingling and MS? Have you found any treatments to be helpful? Share your experience in the comments below, or start a conversation by posting on your Activities page.