Question

I’m in my early forties and have had moderate ME/CFS for about 5 years. I have all the usual symptoms but I now have a new and rather distressing sensation in my arms and sometimes in my legs. It is very similar to the ‘pins and needles’ sensation you can get when your legs have been crossed for too long. These abnormal sensations come and go and don’t seem to be triggered by anything in particular. Is this yet another symptom of ME/CFS? Or do I need to go and see my doctor?

Answer

There are a number of neurological symptoms involving sensation – loss of sensation, increased sensitivity to light, touch, noise, pain, unusual sensations, and ‘pins and needles' – that can occur in ME/CFS. However, it is sometimes very difficult to know whether they are part of ME/CFS or a sign of another unrecognised medical problem.

So other causes of sensory symptoms – such as vitamin B12 deficiency, diabetes, hypothyroidism, monoclonal gammopathy of unknown significance (MGUS) – which can cause numbness or tingling in the hands and feet will need to be considered before simply concluding that this is yet another component of ME/CFS. These sort of sensory symptoms – including ‘pins and needles’ – can also occur during the menopause, in anxiety, and when people breathe too rapidly and hyperventilate.

In these circumstances it is always best to speak with a GP who can take a full history, examine your nervous system and arrange for some investigations, especially where the symptoms are more pronounced, or have more unusual features. The investigation of sensory symptoms in ME/CFS is covered in more detail in the Investigation section of the ME Association Clinical and Research Guide if you want to follow this up.

If the problem continues, and a GP cannot provide a satisfactory explanation, we suggest you ask if you could have a referral to a neurologist – preferably one who is aware of ME/CFS. Simple self-help measures that may be worth trying include massage and the use of soothing aromatic oils such as peppermint, lavender or sandalwood. 

Unfortunately, there isn’t an effective form of drug treatment for pins and needles if it is related to ME/CFS. You could discuss the use of anti-inflammatory drugs such as ibuprofen/Brufen, or the use of a low dose of a sedating tricyclic antidepressant such as amitriptyline. B vitamins are also sometimes recommended but are unlikely to be of benefit unless there is an obvious deficiency.

See also: Nerve Pain.

NHS: Peripheral Neuropathy

Peripheral neuropathy develops when nerves in the body's extremities, such as the hands, feet and arms, are damaged. The symptoms depend on which nerves are affected. In the UK it's estimated almost 1 in 10 people aged 55 or over are affected by peripheral neuropathy.

The main symptoms of peripheral neuropathy can include:

• numbness and tingling in the feet or hands
• burning, stabbing or shooting pain in affected areas
• loss of balance and co-ordination
• muscle weakness, especially in the feet

These symptoms are usually constant, but may come and go. It's important to see a GP if you experience the early symptoms of peripheral neuropathy.

These include:

• pain, tingling or loss of sensation in the feet
• loss of balance or weakness
• a cut or ulcer on your foot that's not getting better

It's also recommended that people at highest risk of peripheral neuropathy, such as people with diabetes, have regular check-ups. A GP will ask about your symptoms and may arrange some tests to help identify the underlying cause. You may be referred to hospital to see a neurologist, a specialist in health problems affecting the nervous system. Generally, the sooner peripheral neuropathy is diagnosed, the better the chance of limiting the damage and preventing further complications.

Source: NHS: Read more…