What is numbness?
Numbness is an abnormal condition in which a person feels tingling or a loss of sensation. Numbness can occur anywhere on the body, but it is most often felt in the extremities, such as the hands, feet, fingers, and toes.
Numbness usually arises from a lack of blood supply to an area or nerve damage. Numbness can also result from infection, inflammation, trauma, and other abnormal processes. Most cases of numbness are not due to life-threatening disorders, but it does occur with stroke and tumors.
Numbness is often associated with or preceded by pain-like pins-and-needles, prickling, or burning sensations called paresthesias. Whereas numbness is a loss of sensation, paralysis involves a loss of movement, with or without the loss of sensation.
Depending on the cause, numbness can disappear quickly, such as numbness in the hand and arm from sleeping on your arm that will fade away once you move your arm around. Chronic numbness in the legs or arms over a long period of time generally indicates some level of damage to the nerves, such as that due to diabetes or multiple sclerosis. Chronic numbness in the fingers may be due to nerve entrapment, as is the case in carpal tunnel syndrome.
Because numbness can be a symptom of an underlying disease, disorder or condition, you should talk with your medical professional about any unusual sensations that last more than a few minutes.
If you experience numbness with loss of bladder or bowel control, paralysis, confusion, weakness in the extremities or slurred speech, seek immediate medical attention in an emergency facility.
What other symptoms might occur with numbness?
Numbness may also be described as a tingling sensation, and numbness after sitting in one position for a long period of time can lead to a pins-and-needles sensation. Numbness most often occurs in the arms, legs, hands and feet, but can happen anywhere in the body. You may experience additional symptoms along with numbness. Any symptoms you notice occurring with numbness can help your doctor make a diagnosis…. Read more about numbness symptoms
What causes numbness?
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…. Read more about numbness causes
What other symptoms might occur with numbness?
Numbness may also be described as a tingling sensation, and numbness after sitting in one position for a long period of time can lead to a pins-and-needles sensation. Numbness most often occurs in the arms, legs, hands and feet, but can happen anywhere in the body. You may experience additional symptoms along with numbness. Any symptoms you notice occurring with numbness can help your doctor make a diagnosis.
Symptoms that may occur along with numbness
Numbness may occur with other symptoms including:
Increased numbness or tingling while walking
Pain in other parts of the body
Pins-and-needles (prickling) sensation
Sensitivity to touch
Serious symptoms that might indicate a life-threatening condition
In some cases, numbness may occur with other symptoms that might indicate a serious or life-threatening condition that should be immediately evaluated in an emergency setting. Get immediate help if you, or someone you are with, are exhibiting any of these life-threatening symptoms:
Confusion or loss of consciousness for even a brief moment
Loss of bladder or bowel control
Loss of vision or changes in vision
Numbness following a head, neck, or back injury
By: Stephen H. Hochschuler, MD
For some people, sciatica pain can be severe and debilitating. For others, the sciatica symptoms might be infrequent and irritating, but have the potential to get worse.
Usually, sciatica only affects one side of the lower body and the pain often radiates from the lower back all the way through the back of the thigh and down through the leg.
Low back pain may be present along with the leg pain, but typically the leg pain is markedly more severe than the low back pain.
Common Sciatica Symptoms
Lower back pain, if experienced at all, is not as severe as leg pain
Constant pain in only one side of the buttock or leg, but rarely both the right and left sides
Pain that originates in the low back or buttock and continues along the path of the sciatic nerve – down the back of the thigh and into the lower leg and foot
Pain that feels better when patients lie down or are walking, but worsens when standing or sitting
Sciatic pain that is typically described as sharp or searing, rather than dull
Some experience a “pins-and-needles” sensation, numbness or weakness, or a prickling sensation down the leg
Weakness or numbness when moving the leg or foot
Severe or shooting pain in one leg that may make it difficult to stand up or walk
Depending on where the sciatic nerve is affected, the pain and other sciatica symptoms may also include foot pain or pain in the toes.
Sciatica Symptoms for each Sciatic Nerve Root
There are two sciatic nerve roots that exit the lumbar spine (L4 and L5) and three that exit the sacral segment (S1, S2 and S3). All five nerves bundle together to form the sciatic nerve, and then branch out again within the leg to deliver motor and sensory functions to specific destinations in the leg and foot.
Sciatica symptoms vary based on where the compressed nerve root is located. For example:
L4 nerve root sciatica
symptoms usually affect the thigh. Patients may feel weakness in straightening the leg, and may have a diminished knee-jerk reflex.L5 nerve root sciatica
symptoms may extend to the big toe and ankle (calledfoot drop
). Patients may feel pain or numbness on top of the foot, particularly on the “web” of skin between the big toe and second toe.S1 nerve root sciatica
affects the outer part of the foot, which may radiate to the little toe or toes. Patients may experience weakness when raising the heal off the ground or trying to stand on tiptoes. The ankle-jerk reflex may also be reduced.Since more than one nerve root may be compressed, patients may experience a combination of the above symptoms.
Sciatica Symptoms that Require Immediate Attention
Rarely, sciatica symptoms that worsen quickly may require immediate surgery. The following symptoms indicate a need for immediate medical care:
Sciatica symptoms that continue to get worse rather than improve, which may indicate possible nerve damage, especially if the progressive symptoms are neurological (such as weakness)
Symptoms that occur in both legs (called bilateral sciatica) and cause either bladder or bowel incontinence or dysfunction, which may indicate cauda equina syndrome. Cauda equina syndrome is an acute compression of one or several nerve roots that occurs relatively rarely, e.g. in 2% of herniated lumbar disc cases.2
Patients should seek immediate medical attention if they experience any of the above symptoms.
Winters ME, Kluetz P, Zilberstein J, “Back Pain Emergencies,” Medical Clinics of North America, 2006:90:505–23.
Physical Therapy and Exercise for Sciatica
By: Stephen H. Hochschuler, MD
Physical therapy exercises – incorporating strengthening, stretching and aerobic conditioning – are a central component of almost any sciatica treatment plan.
When patients engage in a regular program of gentle strengthening, stretching and aerobic exercises, they can recover more quickly from sciatica pain and are less likely to have future episodes of sciatica.
Sciatica exercises usually focus on three key areas:
Many exercises can help strengthen the spinal column and the supporting muscles, ligaments and tendons. Most of these back exercises focus not only on the lower back, but also the abdominal (stomach) muscles and gluteus (buttocks) and hip muscles. Taken together, these strong ‘core’ muscles can provide pain relief because they support the spine, keeping it in alignment and facilitating movements that extend or twist the spine with less chance of injury or damage.Stretching exercises
Stretching is usually recommended to alleviate sciatic pain. Stretches for sciatica are designed to target muscles that cause pain when they are tight and inflexible. Hamstring stretching is almost always an important part of a sciatica exercise program. SeeHamstring Stretching
.Low impact aerobic exercise
Some form of low impact cardiovascular exercise, such as walking, swimming or pool therapy is usually a component of recovery, as aerobic activity encourages the exchange of fluids and nutrients to help create a better healing environment. Aerobic conditioning has the unique benefit of releasing endorphins, the body’s natural pain killers, which helps reduce sciatic pain.The specific sciatica exercises will depend on the underlying medical condition causing the sciatica pain, as well as a number of other factors, such as the patient’s level of pain and overall conditioning.
By: Stephen H. Hochschuler, MD
For severe or ongoing flare-ups of sciatic nerve pain, the condition may need to be treated so that it does not get worse over time.
For most, readily available nonsurgical remedies and regular exercise will go a long way to relieving their pain.
For others, when the pain is severe or does not get better on its own, a more structured treatment approach, and possibly surgery, may offer the best approach to finding pain relief and preventing or minimizing future flare-ups of sciatica.
This page addresses nonsurgical treatment for sciatica. For more treatment options, see also Physical Therapy Exercises and Sciatica Surgery (links below).
Non-Surgical Treatment for Sciatica
Non-surgical sciatica treatments encompass a broad range of options, with the goal of relieving pain caused by compressed nerve roots. One or some combination of the treatments below are usually recommended in conjunction with a specific exercise program.
For acute sciatic pain, heat and/or ice packs are readily available and can help alleviate the leg pain, especially in the initial phase. Usually ice or heat is applied for approximately 20 minutes, and repeated every two hours. Most people use ice first, but some people find more relief with heat. The two may be alternated.
Sciatica Pain Medications
Over-the-counter or prescription medications may also be helpful in relieving sciatica. Non-steroidal anti-inflammatory drugs (such as ibuprofen, naproxen, or COX-2 inhibitors), or oral steroids can be helpful in reducing the inflammation that is usually a contributing factor in causing sciatica pain.
Epidural Steroid Injections for Sciatica
If the sciatica pain is severe, an epidural steroid injection can be performed to reduce the inflammation. An epidural injection is different from oral medications because it injects steroids directly to the painful area around the sciatic nerve to help decrease the inflammation that may be causing the pain. While the effects tend to be temporary (providing pain relief for as little as one week up to a year), and it does not work for everyone, an epidural steroid injection can be effective in providing relief from an acute episode of sciatic pain. Importantly, it can provide sufficient relief to allow a patient to progress with a conditioning and exercise program.