Restlessness/ pins and needles

16 February 2017.

Restlessness is an uncomfortable feeling of being unable to be still and relaxed, or feeling as though you’re on edge and something is about to, or needs to, happen. It can be physical, and/ or psychological in nature and is associated with various hormone-related health conditions; especially anxiety [1], migraine [2], and iron deficiency anaemia [3]. Although the exact cause of hormone-related restlessness is unknown, it is thought to involve hormones such as oestrogen, thyroxine, and dopamine [4].

Pins and needles‘ is an English expression for describing a pricking, burning, tingling or numbing sensation that’s usually felt in the arms, legs, hands, or feet, when blood flow is somehow restricted to that part of the body. It doesn’t usually cause any pain, but it can cause temporary numbness or itching [5].

Many people experience restlessness, and/ or pins and needles, in the week before menstruation and it typically occurs alongside other symptoms such as sleep problems, or poor temperature control [6].

Related symptoms: anaemiaanxietymigrainepoor temperature control; or sleep problems.


Medical conditions to rule out first:

  • Restless leg syndrome (also known as Willis-Ekbom disease) is a common condition of the nervous system that causes an overwhelming, irresistible urge to move the legs. It can also cause an unpleasant crawling or creeping sensation in the feet, calves and thighs. The sensation is often worse in the evening or at night. Occasionally, the arms are affected too. This condition is much more prevalent during pregnancy.

Note: Most cases of pins and needles are temporary and the sensation disappears after the pressure is taken off the affected area. See your doctor if you constantly have pins and needles or if it keeps coming back. It may be a sign of a more serious underlying health condition;

  • a condition that damages the nervous system – such as a strokemultiple sclerosis or in extremely rare cases, a brain tumour
  • exposure to toxic substances – such as lead or radiation
  • certain types of medication – such as HIV medication, medication to prevent seizures (anticonvulsants), or some antibiotics 
  • malnutrition – where the body lacks important nutrients because of a poor diet
  • vitamin B12 deficiency
  • nerve damage caused by infection, injury or overuse – for example, a condition known as hand-arm vibration syndrome may be the result of regularly using vibrating tools
  • alcohol misuse
  • cervical spondylosis – the bones and tissues of the spine can wear down over time, leading to trapped nerves and occasionally pins and needles

TOP TIPS: During an episode of restlessness, the following measures may help relieve your symptoms: massaging your legs; taking a hot bath in the evening; applying a hot or cold compress to your leg muscles; doing activities that distract your mind, such as reading or watching television; relaxation exercises, such as yoga or tai chiwalking and stretching

Try a hormone-balancing diet– As outlined in this blog, a vegetable-based ‘anti-inflammatory’ diet can significantly improve all hormone-related symptoms.

We highlight additional advice for those suffering from hormone-related restlessness/ pins and needles, below;

  1. Eat lots of fresh fruit and vegetables
  2. Eat lots of fibre (and drink water with it)
  3. Eat oily foods (mainly unsaturated fats)
  4. Reduce meat and dairy products
  5. Avoid sugary foods and drinks
  6. Avoid caffeine- and other stimulants, especially at night-time [7].
  7. Avoid alcohol (and smoking)- these can worsen the feeling of restlessness [7].
  8. Take nutritional supplements- Iron supplements can significantly reduce restlessness in people who are anaemic [7], studies also suggest that Vitamin C [8], Vitamin D [9] and Vitamin E [8] deficiencies may be a factor in restlessness, especially in restless leg syndrome.

Take regular daily exercise – but avoid exercising near bedtime [7].

Practice good sleeping habits – for example, going to bed and getting up at the same time every day, not napping during the day, taking time to relax before going to bed, and avoiding caffeine close to bedtime [7].

A small medical trial carried out in 2011 found a type of osteopathic exercise technique called positional release manipulation could be of benefit to people with restless legs syndrome. It involves holding different parts of the body in positions found to reduce feelings of pain and discomfort [10].


If you have tried the suggested tips and tricks for at least 3 months, and your symptoms do not improve, please consult your doctor.

If you have any suggestions, or tips, for managing restlessness/ pins and needles- please let us know– we can share them with others!


Further information:


Page last reviewed and updated: June 2018


References:

1. Becker PM, Sharon D. (2014) Mood disorders in restless legs syndrome (Willis-Ekbom disease). J Clin Psychiatry. Jul;75(7):e679-94. doi: 10.4088/JCP.13r08692. Review. PubMed PMID: 25093484

2. Lin GY, Lin YK, Lee JT, Lee MS, Lin CC, Tsai CK, Ting CH, Yang FC. (2016) Prevalence of restless legs syndrome in migraine patients with and without aura: a cross-sectional, case-controlled study. J Headache Pain. Dec;17(1):97

3. Auerbach M, Adamson JW. (2016) How we diagnose and treat iron deficiency anemia. Am J Hematol. Jan;91(1):31-8. doi: 10.1002/ajh.24201. Epub Nov 17. Review. PubMed PMID: 26408108.

4. Pereira JC Jr, Rocha e Silva IR, Pradella-Hallinan M. (2013) Transient Willis-Ekbom’s disease (restless legs syndrome) during pregnancy may be caused by estradiol-mediated dopamine overmodulation. Med Hypotheses. Feb;80(2):205-8. doi: 10.1016/j.mehy.2012.11.030

5. NHS. (2016) Pins and needles. [ONLINE] Available at: http://www.nhs.uk/Conditions/Pins-and-needles/Pages/Introduction.aspx. [Accessed 14 September 2017]

6. Strine TW, Chapman DP, Ahluwalia IB. (2005) Menstrual-related problems and psychological distress among women in the United States. J Womens Health (Larchmt).  May;14(4):316-23. PubMed PMID: 15916505

7. NHS (2015) Restless leg syndrome. [ONLINE] Available at: http://www.nhs.uk/Conditions/Restless-leg-syndrome/Pages/Treatment.aspx. [Accessed 14 September 2017]

8. Winkelman JW, Armstrong MJ, Allen RP, Chaudhuri KR, Ondo W, Trenkwalder C, Zee PC, Gronseth GS, Gloss D, Zesiewicz T. (2016) Practice guideline summary: Treatment of restless legs syndrome in adults: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology.  Neurology. Dec 13;87(24):2585-2593. Epub 2016 Nov 16. PubMed PMID: 27856776; PubMed Central PMCID: PMC5206998

9. Wali S, Shukr A, Boudal A, Alsaiari A, Krayem A. (2015) The effect of vitamin D supplements on the severity of restless legs syndrome. Sleep Breath. May;19(2):579-83. doi: 10.1007/s11325-014-1049-y. Epub 2014 Aug 23. Erratum in: Sleep Breath. 2015 Dec;19(4):1483. PubMed PMID: 25148866

10. MacDonald, R.Peters, T. and Leach, Carolyn (2011) A randomized controlled pilot trial of positional release manipulation (counterstrain) in the treatment of restless legs syndrome International Musculoskeletal Medicine, 33 (1). pp. 21-25. ISSN 1753-6146


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