Why Do We Feel 'Pins and Needles' When our Appendages Fall Asleep?

Medical Treasure

We've all experienced the strange sensation. Maybe it's when your alarm goes off in the morning and you realize you can't feel your arm to shut it off. Or when your legs are folded into a pretzel on the floor while playing Barbie with your kid and you can't stand back up. You give your dead appendages a shake, and suddenly you feel a surge of pins and needles. What causes that feeling?

There's actually a medical term for it  – paresthesia – defined as the tingling sensation caused by pressure or damage to peripheral nerves.

Don't pinch these! Gray's Anatomy
(Wikimedia Commons)

It occurs when there's prolonged pressure on a limb, like your arm positioned awkwardly under your head while sleeping or sitting cross-legged on the floor. The limb "falls asleep," either due to (1) arteries being compressed, thus blocking blood flow of oxygen and glucose to feed the nerves, or (2) directly pinching nerve pathways, causing normal neurotransmission to slow or cease.

Although your limbs may feel lifeless, your brain is receiving a signal of pain, saying "change your position already, idiot!" When you finally free your limb, the sensation of pain intensifies as blood returns to the area and nerves begin firing regularly. The "pins and needles" sensation occurs as certain areas nerve fibers receive blood nutrients and begin re-firing before others. Eventually, after a few seconds, equilibrium is established again.

A common misconception is that blood flow is blocked entirely to the affected limb when it "falls asleep." If that were true, we'd be experiencing a much more serious medical problem. Luckily, the 50,000-60,000 miles-worth of capillaries in our bodies ensure that our other tissues stay satiated and healthy. It would be as though a tourniquet were applied to a limb, and that's simply not what's happening.

Prolonged, regular compression to nerves can result in a more long-term sensation of "pins and needles," such as carpal tunnel syndrome. Consult a doctor if pain, tingling, and numbness is not relieved when you change body position.

Now, I'm going to undo my leg from under me (as I always do when I write) and go for a short walk to wake it back up. OUCH. Sometimes I never learn.