“All of us at anxietycentre.com have experienced debilitating anxiety. But we’ve also overcome it and returned to normal and lasting health. Because we know the hardship anxiety unwellness can cause, we are committed to helping others, with over 30 years of service.” - Jim Folk, President, anxietycentre.com

Tingling, Pins and Needles, Paresthesia Anxiety Symptoms

Marilyn Folk BScN medical reviewer
Written by: Jim Folk.
Medically reviewed by: Marilyn Folk, BScN.
Last updated: July 24, 2019


tingling, pins and needles anxiety symptoms

Tingling, pins and needles, paresthesia anxiety symptoms feelings anywhere on or in the body

Common descriptions include:

  • A tingling sensation anywhere on or in the body, including the hands, feet, fingers, toes, head, face, arms, chest, back, groin, mouth, etc.
  • Pins and needles feeling, numbness, pressure, or trembling sensations on or in your arms, hands, legs, feet, head, face, or anywhere on or in the body.
  • Paresthesia feeling anywhere on or in the body.
  • A tingling numbness, prickly feeling anywhere on or in the body.

You might experience one, many, or all of these sensations.

These tingling, tingly, pins and needles anxiety symptoms can persistently affect one area only, can shift and affect another area or areas, and can migrate all over the body and affect many areas over and over again.

These tingling, tingly, pins and needles anxiety symptoms can come and go rarely, occur frequently, or persist indefinitely. For example, you might feel a pins and needles feeling once and a while and not that often, feel it off and on, or feel it all the time.

These tingling, tingly, pins and needles anxiety symptoms can precede, accompany, or follow an escalation of other anxiety sensations and symptoms, or occur by itself.

These tingling, tingly, pins and needles anxiety symptoms can precede, accompany, or follow an episode of nervousness, anxiety, fear, and stress, or occur “out of the blue” and for no apparent reason.

These tingling, tingly, pins and needles anxiety symptoms can range in intensity from slight, to moderate, to severe. They can also come in waves, where they are strong one moment and ease off the next.

These tingling, tingly, pins and needles anxiety symptoms can change from day to day and from moment to moment.

All of the above combinations and variations are common.

These tingling, tingly, pins and needles anxiety symptoms can seem more disconcerting when undistracted, trying to rest, trying to do a deep relaxation technique, or going to or waking up from sleep.

What causes tingling, tingly, pins and needles feelings?

Tingling, tingly, pins and needles feelings can be caused by a number of factors including:

  • Remaining in the same position (seated or standing) for a long time.
  • Injury or pressure on a nerve (for example, a back injury can cause numbness in the legs or feet, and a neck injury can cause numbness in the arms and hands).
  • Pressure on the spinal nerves (for example, due to a herniated disk).
  • Lack of blood supply to an area (for example, restricted blood flow–we often refer to it as “falling asleep,” or for medical reason such as, plaque buildup from atherosclerosis–this can cause pain, numbness, and tingling).
  • Side effects from certain medications.
  • A lack of vitamin B12 or other vitamins.
  • From radiation therapy.
  • Toxic action on the nerves, such as from alcohol, tobacco, or lead.
  • Abnormal levels of calcium, potassium, or sodium in the body.

Tingling, tingly, pins and needles feelings can also be caused by other medical conditions, including:

  • Carpal tunnel syndrome
  • Diabetes
  • Migraines
  • Multiple sclerosis
  • Seizures
  • Stroke
  • Transient ischemic attack (TIA)
  • Underactive thyroid
  • Hyperventilation
  • Hypoventilation
  • Pinched nerve
  • Circulation problems
  • Reaction to medication
  • Allergic reaction
  • Tight muscles
  • A variety of medical illnesses
  • Vitamin B deficiency

Medical Advisory

We recommend all new, changing, persistent, and returning anxiety symptoms be discussed with your doctor as some medical conditions and medications can cause anxiety-like symptoms, including this anxiety symptom. If your doctor concludes your symptoms are solely anxiety-related, you can be confident there isn't a medical cause. Generally, doctors can easily determine the difference between anxiety symptoms and those caused by a medical condition.

Doctors aren't infallible, however. If you are uncertain about your doctor’s diagnosis, you can seek a second or more opinions. But if all opinions agree, you can be assured anxiety is the cause of this symptom.

Why can anxiety cause the tingling, tingly, pins and needles feeling?

When this symptom is caused by anxiety, there can be many factors that cause the tingly, tingling, pins and needles feeling. Here are the seven most common:

1. Being anxious has activated an active stress response

Being stressed and anxious (worried, apprehensive, fretful, fearful) activate the stress response. The stress response secretes stress hormones into the bloodstream where they travel to targeted spots in the body to bring about specific physiological, psychological, and emotional changes that enhance the body’s ability to deal with a threat—to either fight with or flee from it—which is the reason the stress response is often referred to as the fight or flight response.[1][2][3]

A part of the stress response changes includes shunting blood away from parts of the body less vital to survival and to parts more vital to survival. This shunting action can cause a tingling, tingly, pins and needles feeling in various parts of the body when a stress response has been activated.

The stress response also heightens our senses and stimulates the body, especially the nervous system. These actions can cause a tingling, tingly, pins and needles, paresthesia sensation and feelings.

2. Stress-response hyperstimulation

When stress responses occur infrequently, the body can recover relatively quickly from the physiological, psychological, and emotional changes the stress response brings about. When stress responses occur too frequently or dramatically, however, such as from overly apprehensive behavior, the body has a more difficult time recovering. This can cause it to remain in a state of semi stress response readiness. We call this state “stress-response hyperstimulation” since stress hormones are stimulants (also often referred to as "hyperarousal").[4][5]

A body that becomes hyperstimulated can behave oddly and erratically, which can be particularly noticeable because of how hyperstimulation affects the nervous system.[6]

The nervous system is responsible for sending and receiving sensory information to and from the brain. A main component of the nervous system is specialized cells called neurons (nerve cells), which communicate with each other using an electrochemical process (the combination of electricity and chemistry).[7]

For example, when nerve impulse information is received from one of the body’s senses, neurons relay this nerve impulse information through the nervous system network to the brain for interpretation. And if we want to move a particular muscle or group of muscles, nerve impulse information is sent from the brain through the nervous system network to the particular muscle or groups of muscles to bring about movement (muscles move through a combination of nerve impulse-triggered muscle contractions and releases). Again, this nerve impulse information is conveyed electrochemically by the neurons through the nervous system network.

This system of communication and reaction works normally when the body and nervous system are healthy. Problems can occur, however, when they become stress-response hyperstimulated.

For example, because of their electrochemical properties, neurons are particularly sensitive to stress hormone stimulation. When neurons become overly stimulated, they can act erratically and more involuntarily than normal, which can cause them to “misreport,” “over report,” and send “false” nerve impulse information to and from the brain.[8] These abnormalities can cause a wide range of sensory and physical anomalies, such as experiencing a tingling, tingly, pins and needles, paresthesia feeling.

Moreover, hyperstimulation can cause the electrical activity in the brain to increase,[9] which can cause neurons to become even more unstable, neurons can fire even more erratically and involuntarily when the body, brain, and nervous system become hyperstimulated.[10]

The combination of the above factors can cause a wide range of odd and bizarre behaviors, sensations, and feelings. Experiencing tingling, tingly, pins and needles sensations is an example.

3. Hyper- or hypoventilation

Hyper- or hypoventilation is another cause of tingling in head symptoms.[11] When we breathe too shallowly and don’t take in enough oxygen (hypoventilation), this causes the CO2 levels in the blood to drop, which can cause a tingling, tingly, pins and needles sensation anywhere on or in the body. Some people describe this feeling as an effervescence, prickly, or crawly sensation.

If, on the other hand, you are breathing too aggressively and take in too much oxygen, this can also change the CO2 levels in the blood causing hyperventilation, which can also cause a tingling, tingly, pins and needles sensation anywhere on or in the body, as well.

Even though these tingling, tingly, pins and needles symptoms can seem odd and even unsettling, they are harmless and needn’t be a cause for concern. They will subside when you reverse the above causes.

4. Muscle tension

Stress, including the stress caused by stress responses, causes the body’s muscles to tense and tighten.[12] This tension can cause muscle and muscle groups to experience a tingling, tingly, pins and needles feeling.

5. Vitamin B deficiency

Stress taxes the body’s resources harder than normal, which can affect the body’s nutrients, including vitamins. Stress commonly causes a reduction in the body’s vitamin B. Vitamin B deficiency can also cause a tingling, tingly, pins and needles sensation.[13]

6. Circulation problems

Similar to point 4, stress causes the body’s muscles to tense and tighten. As the body’s stress elevates, muscle tension can restrict arteries, which can reduce blood flow (circulation). When blood flow is restricted, we can experience tingling, tingly, pins and needles sensations in the parts of the body that aren’t receiving sufficient blood flow.

7. Reaction to medication

The adverse effects of medications, including anti-anxiety and antidepressant medications, can cause tingling, tingly, pins and needles sensations.

NOTE: If you are having tingling, tingly, pins and needles, and paresthesia sensations due to medication, contact your doctor as soon as possible.

This list is not exhaustive but does represent the majority of anxiety-related causes of the tingling, tingly, pins and needles anxiety symptoms.

How to get rid of anxiety caused tingling, tingly, pins and needles anxiety symptoms?

When tingling, tingly, pins and needles anxiety symptoms are caused by apprehensive behavior (anxiety) and the accompanying stress response changes, calming yourself down will bring an end to the stress response and its changes. As your body recovers from the active stress response, this tingling in head feeling should subside and you should return to your normal self. Keep in mind that it can take up to 20 minutes or more for the body to recover from a major stress response. But this is normal and shouldn’t be a cause for concern.

When this feeling is caused by hyperstimulation, it may take a lot longer for the body to recover to where the tingling, tingly, pins and needles, paresthesia symptoms subside. We explain the many complications of recovery from hyperstimulation in Chapters 2, 3, and 14 in the Recovery Support area of our website.

Nevertheless, when the body has recovered from either an active stress response or hyperstimulation, this tingling, tingly sensation will disappear. Therefore, these tingling sensations, feelings, and symptoms needn’t be a cause for concern.

You can speed up the recovery process by reducing your stress, practicing relaxed breathing, increasing your rest, and not worrying about this symptom. Sure, tingling feelings can be unsettling and even bothersome. But again, when your body has recovered from the stress response or chronic stress (hyperstimulation), these tingly symptoms will subside.

When tingling, tingly, pins and needles anxiety symptoms are caused by hyper- or hypoventilation, regulating your breathing to a normal pattern will restore the proper CO2 levels in the blood. Proper CO2 balance will eliminate ventilation caused tingling, tingly, pins and needles symptoms.

When tingling, tingly, and pins and needles feelings are caused by an adverse reaction to medication, speak with your doctor and pharmacist about reducing, switching, or discontinuing the medication.

When the tingling, tingly, pins and needles feelings are caused by chronic stress, such as from overly apprehensive behavior, there are typically NO quick-fix cures for this symptom. Eliminating it requires regularly practicing the strategies mentioned above and for long enough for the body to recover. But as with all sensations and symptoms of stress (including the stress caused by overly anxious behavior), they completely disappear when the body’s stress is returned to a normal level and the body has sufficient time to recover. So again, anxiety- and stress-caused tingling, tingly, pins and needles, and paresthesia sensations needn’t be a cause for concern. They are merely indications of an active stress response or hyperstimulation (chronic stress).

If your anxiety symptoms are persisting longer than you think they should, you may want to join our Recovery Support area and read about the many recovery considerations. Chapters 3, 4, 5, 6, 7, and 14 contain vital information about recovery and recovery expectations.

If you are having a difficult time managing your anxiety and worry, you might want to consider connecting with one of our recommended anxiety disorder therapists. All of them have personally experienced and have successfully overcome anxiety disorder. Their personal experience with anxiety disorder coupled with their professional training has equipped them to help all anxiety disorder sufferers, no matter the symptom mix, severity, or how long the person has struggled with anxiety disorder.

Working with an experienced anxiety disorder therapist is the most effective way to overcome anxiety disorder.[14][15][16]


The combination of good self-help information and working with an experienced anxiety disorder therapist is the most effective way to address anxiety disorder and its many symptoms. Until the core causes of anxiety are addressed - the underlying factors that motivate apprehensive behavior - a struggle with anxiety disorder can return again and again. Identifying and successfully addressing anxiety's underlying factors is the best way to overcome problematic anxiety.


Additional Resources:


Return to Anxiety Disorders Signs and Symptoms section.

anxietycentre.com: Information, support, and coaching/counseling/therapy for problematic anxiety and its sensations and symptoms, including the tingling, tingly, pins and needles anxiety symptoms.


REFERENCES:

1. Selye H. Endocrine reactions during stress. Anesthesia & Analgesia. 1956;35:182–193. [PubMed]

2. "Understanding the Stress Response - Harvard Health." Harvard Health. N.p., n.d. Web. 23 May 2016.

3. "The Physiology of Stress: Cortisol and the Hypothalamic-Pituitary-Adrenal Axis." DUJS Online. N.p., 03 Feb. 2011. Web. 19 May 2016.

4. Selye, H. (1956). The stress of life. New York, NY, US: McGraw-Hill.

5. Teixeira, Renata Roland, et al. “Chronic Stress Induces a Hyporeactivity of the Autonomic Nervous System in Response to Acute Mental Stressor and Impairs Cognitive Performance in Business Executives.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, 2015.

6. Yaribeygi, Habib, et al. “The Impact of Stress on Body Function: A Review.” EXCLI Journal, Leibniz Research Centre for Working Environment and Human Factors, 2017.

7. Bear,Connors, Paradiso (2016). Neuroscience: Exploring the brain - Fourth Edition. In Neurons And Glia (pp. 29-53). New York, NY: Wolters Kluwer

8. Hannibal, Kara E., and Mark D. Bishop. “Chronic Stress, Cortisol Dysfunction, and Pain: A Psychoneuroendocrine Rationale for Stress Management in Pain Rehabilitation.” Advances in Pediatrics., U.S. National Library of Medicine, Dec. 2014.

9. Z, Fatahi, et al. "Effect of acute and subchronic stress on electrical activity of basolateral amygdala neurons in conditioned place preference paradigm: An electrophysiological study." Behavioral Brain Research, 29 Sept. 2017.

10. Justice, Nicholas J., et al. “Posttraumatic Stress Disorder-Like Induction Elevates β-Amyloid Levels, Which Directly Activates Corticotropin-Releasing Factor Neurons to Exacerbate Stress Responses.” Journal of Neuroscience, Society for Neuroscience, 11 Feb. 2015.

11. 4. Meuret, Alicia E., and Thomas Ritz. “Hyperventilation in Panic Disorder and Asthma: Empirical Evidence and Clinical Strategies.” NCBI PubMed, U.S. National Library of Medicine, Oct. 2010.

12. 6. Takahashi, Sho. “Importance of Cervicogenic General Dizziness.” NCBI PubMed, U.S. National Library of Medicine, May 2018.

13. “Vitamin B12 Deficiency: Causes, Symptoms, and Treatment.” WebMD, WebMD, July 2019.

14. Hofmann, Stefan G., et al. “The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-Analyses.” Cognitive Therapy and Research, U.S. National Library of Medicine, 1 Oct. 2012.

15. Leichsenring, Falk. “Is Cognitive Behavioral Therapy the Gold Standard for Psychotherapy?” JAMA, American Medical Association, 10 Oct. 2017.

16. "CBT can be recommended as a gold standard in the psychotherapeutic treatment of patients with anxiety disorders." - Otte, Christian. "Cognitive Behavioral Therapy in Anxiety Disorders: Current State of the Evidence." Dialogues in Clinical Neuroscience. Les Laboratoires Servier, Dec. 2011. Web. 14 Sept. 2016.