Tingling, Prickly, Pins and Needles, Paresthesia Anxiety Symptoms
Tingling, tingly, prickly, trembling, pressure, numbness, and pins and needles, paresthesia feelings in the arms, legs, hands, feet, head, face, chest, or anywhere on or in the body are common anxiety symptoms, including anxiety and panic attack symptoms.
This article explains the relationship between anxiety and tingling, tingly, prickly, and pins and needles symptoms.
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Tingling, Tingly, Prickly, Pins and Needles Common Anxiety Symptom Descriptions
- A tingling sensation anywhere on or in the body, including the hands, feet, fingers, toes, head, face, neck, arms, chest, back, groin, mouth, etc.
- A pins and needles feeling, numbness, pressure, or trembling sensations on or in your arms, hands, legs, feet, head, face, neck, or anywhere on or in the body.
- It can also feel like a prickly sensation.
- Paresthesia (tingling, prickly, pins and needles) 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 these sensations.
These tingling, tingly, prickly, pins and needles symptoms can persistently affect one area only, shift and affect another area or areas, and migrate all over and affect many areas repeatedly.
Tingling, prickly, pins and needles symptoms can:
- Occur occasionally, frequently, or persistently.
- Precede, accompany, or follow an escalation of other anxiety symptoms or occur by itself.
- Precede, accompany, or follow a period of nervousness, anxiety, fear, and stress, or occur "out of the blue" for no reason.
- Range in intensity from mild, to moderate, to severe.
- Come in waves where it’s strong one moment and eases off the next.
- Occur for a while, subside, and then return for no reason.
- Change from day to day, moment to moment, or remain as a constant background during your struggle with anxiety disorder.
This symptom can seem more noticeable when undistracted, resting, trying to sleep, or waking up.
All the above combinations and variations are common.
To see if anxiety might be playing a role in your symptoms, rate your level of anxiety using our free one-minute instant results Anxiety Test, Anxiety Disorder Test, or Hyperstimulation Test.
The higher the rating, the more likely anxiety could be contributing to or causing your anxiety symptoms, including feeling like impending doom symptoms.
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Causes
Medical Advisory
Talk to your doctor about all new, changing, persistent, and returning symptoms as some medical conditions and medications can cause anxiety-like symptoms.
What causes tingling, pins and needles feelings?
Tingling, tingly, pins and needles feelings can have many causes 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 a 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
- Recreational drug
The sensations associated with this symptom can also be caused by other medical conditions, including:
- Carpal tunnel syndrome
- Ulnar nerve compression
- 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
And so on.
Anxiety Causes
When tingling, tingly, prickly, and pins and needles symptoms are solely related to anxiety, there can be many causes. The most common include:
1. Activated Stress Response
Anxious behavior, such as worry, activates the stress response, which secretes stress hormones into the bloodstream, where they travel to specific locations to immediately prepare the body for emergency action – to fight or flee. This instinctual survival reaction is often referred to as the Fight or Flight Response [1][2].
Visit the “Stress Response” article to learn how it can affect the body.
Some of the stress response changes include:
- Quickly converts the body’s energy reserves into “fuel” (blood sugar) to instantly boost energy.
- Increases heart rate, respiration, and metabolism due to the boost in energy, increasing blood pressure.
- Stimulates the sympathetic nervous system, increasing nervous system activity to be more sensitive and reactive to danger.
- Heightens most of the body’s senses to be more aware of danger.
- Increases activity in the amygdala (the brain’s fear center) and decreases activity in the prefrontal cortex (the rationalization area of the brain) so that our attention is focused on the threat and away from thoughts that could be distracting.
- Shunts blood to parts of the body vital to survival, such as the brain, arms, legs, muscles, and vital organs, and away from parts less essential for survival, such as the stomach, digestive system, and skin. It accomplishes this by constricting blood vessels in certain parts of the body and dilating them in others.
- Tightens muscles to make the body more resilient to injury.
- Suppresses the immune system so that most of the body’s resources are used for emergency action.
- Increases respiration to accommodate the increase in heart rate.
- Increases perspiration to keep the body cool and expel toxins.
- Taxes the body’s energy and nutritional resources harder and faster than usual.
To name a few.
Any combination of stress response changes can cause a tingling, tingly, prickly, and pins and needles sensation anywhere on or in the body.
2. Hyperstimulation
When stress responses occur infrequently, the body recovers relatively quickly from its changes. However, frequently activated stress responses, such as from overly anxious behavior, can prevent the body from completely recovering. Incomplete recovery can leave the body in a state of semi-stress-response-readiness, which we call “stress-response hyperstimulation” since stress hormones are powerful stimulants.
Hyperstimulation is also often referred to as “hyperarousal,” “HPA axis dysfunction,” or “nervous system dysregulation” [3][4].
Visit our “Hyperstimulation” article for more information about the many ways hyperstimulation can affect the body and how we feel.
Hyperstimulation can cause the changes of an active stress response even though a stress response hasn’t been activated.
Just as an active stress response can cause acute tingling, tingly, prickly, and pins and needles symptoms, hyperstimulation can cause chronic symptoms.
But that’s not all. Hyperstimulation can cause this symptom in other ways. For instance, hyperstimulation can cause:
- Nervous System Excitation and Dysregulation [5][6]: A chronically stimulated nervous system can act erratically and cause all kinds of nervous, sensory, circulatory, skeletal, muscular, somatic, and vestibular (equilibrium) system problems, causing a wide range of symptoms, including tingling, tingly, prickly, and pins and needles symptoms.
- Homeostatic Dysregulation [7][8]: Homeostasis is the body’s ability to automatically maintain a stable internal environment despite changes in the external environment. Hyperstimulation can cause homeostatic dysregulation, leading to internal regulation problems, which can affect the nervous, sensory, circulatory, skeletal, muscular, somatic, and vestibular systems, causing a wide range of symptoms, including tingling, tingly, prickly, and pins and needles symptoms.
- Hormone changes [9]: Hormones play a crucial role in homeostasis and many bodily functions, which can affect the nervous, sensory, and vestibular systems. Since stress hormones affect other hormones, hyperstimulation can affect all the bodily systems, causing a wide range of symptoms, including tingling, tingly, prickly, and pins and needles symptoms.
- Sleep disruption and fatigue [10]: Hyperstimulation can interfere with sleep and tax the body’s energy resources harder and faster than normal. Sleep disruption and fatigue can affect all bodily systems, causing a wide range of symptoms, including tingling, tingly, prickly, and pins and needles.
As long as the body is hyperstimulated, it can exhibit chronic tingling, tingly, prickly, and pins and needles symptoms.
3. Hyper- or hypoventilation
Hyper- or hypoventilation is another cause of this symptom.
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, prickly, 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 breathe 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, prickly, pins and needles sensation anywhere on or in the body, as well.
4. Muscle tension
Stress causes the body’s muscles to tense and tighten. Chronic stress (hyperstimulation) can cause chronic muscle tension, which can cause the sensations associated with this symptom.
5. Vitamin B deficiency
Stress taxes the body’s energy and nutritional resources harder than normal, which can affect the body’s nutrients, including vitamins. For instance, chronic stress (hyperstimulation) can cause a reduction in vitamin B. Vitamin B deficiency can also cause a tingling, tingly, prickly, pins and needles sensation.
6. Circulation problems
Like point 4, stress, including anxiety-caused stress, causes the body’s muscles to tense and tighten. As the body’s level of stress elevates, muscle tension can restrict arteries, reducing 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 the sensations associated with this symptom.
This list is not exhaustive but does represent the majority of anxiety-related causes of this symptom.
Even though this symptom can seem odd, stress- and anxiety-caused sensations, including this one, are harmless and, therefore, needn’t be a cause for concern. This symptom will disappear when we’ve eliminated hyperstimulation.
8. Other Factors
Other factors can create stress and cause anxiety-like symptoms, as well as aggravate existing anxiety symptoms, including:
- Recreational drugs
- Stimulants
- Sleep deprivation
- Fatigue
- Low blood sugar
- Nutritional deficiencies
- Dehydration
- Hormone changes
- Pain
Select the relevant link for more information.
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Treatment
When other factors cause or aggravate this anxiety symptom, addressing the specific cause can reduce and eliminate this symptom.
When an active stress response causes this symptom, ending the active stress response will cause this acute anxiety symptom to subside.
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 needn’t be a cause for concern.
When hyperstimulation (chronic stress) causes tingling, tingly, prickly, and pins and needles symptoms, eliminating hyperstimulation will end this anxiety symptom.
You can eliminate hyperstimulation by:
- Reducing stress.
- Containing anxious behavior (since anxiety creates stress).
- Regular deep relaxation.
- Avoiding stimulants.
- Regular light to moderate exercise.
- Eating a healthy diet of whole and natural foods.
- Passively accepting your symptoms until they subside.
- Being patient as your body recovers.
Visit our “60 Natural Ways To Reduce Stress” article for more ways to reduce stress.
Recovery Support members can view chapters 5, 6, 7, 14 and more for more detailed information about recovering from hyperstimulation and anxiety disorder.
As the body recovers from hyperstimulation, it stops sending symptoms, including this one.
Symptoms of chronic stress subside as the body regains its normal, non-hyperstimulated health.
However, eliminating hyperstimulation can take much longer than most people think, causing symptoms to linger longer than expected.
As long as the body is even slightly hyperstimulated, it can present symptoms of any type, number, intensity, duration, frequency, and at any time, including this one.
Even so, since this is a common symptom of stress, including anxiety-caused stress, it's harmless and needn't be a cause for concern. It will subside when unhealthy stress has been eliminated and the body has had sufficient time to recover. Therefore, there is no reason to worry about it.
Anxiety symptoms often linger because:
- The body is still being stressed (from stressful circumstances or anxious behavior).
- Your stress hasn't diminished enough or for long enough.
- Your body hasn't completed its recovery work.
Addressing the reason for lingering symptoms will allow the body to recover.
Most often, lingering anxiety symptoms ONLY remain because of the above reasons. They AREN'T a sign of a medical problem. This is especially true if you have had your symptoms evaluated by your doctor and they have been solely attributed to anxiety or stress.
Chronic anxiety symptoms subside when hyperstimulation is eliminated. As the body recovers and stabilizes, all chronic anxiety symptoms will slowly diminish and eventually disappear.
Since worrying and becoming upset about anxiety symptoms stress the body, these behaviors can interfere with recovery.
Passively accepting your symptoms – allowing them to persist without reacting to, resisting, worrying about, or fighting them – while doing your recovery work will cause their cessation in time.
Acceptance, practice, and patience are key to recovery.
Keep in mind that it can take a long time for the body to recover from hyperstimulation. It's best to faithfully work at your recovery despite the lack of apparent progress.
However, if you persevere with your recovery work, you will succeed.
You also have to do your recovery work FIRST before your body can recover. The cumulative effects of your recovery work will produce results down the road. And the body's stimulation has to diminish before symptoms can subside.
- Reducing stress.
- Increasing rest.
- Faithfully practicing your recovery strategies.
- Passively accepting your symptoms.
- Containing anxious behavior.
- Being patient.
These will bring results in time.
When you do the right work, the body has to recover!
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Recovery Support
The Recovery Support area of our website contains thousands of pages of important self-help information to help individuals overcome anxiety disorder, hyperstimulation, and symptoms.
Due to the vast amount of information, including a private Discussion Forum, many of our Recovery Support members consider it their online recovery support group.
Therapy
Unidentified and unaddressed underlying factors cause issues with anxiety. As such, they are the primary reason why anxiety symptoms persist.
Addressing your underlying factors (Level Two recovery) is most important if you want lasting success.
Addressing Level Two recovery can help you:
- Contain anxious behavior.
- Become unafraid of anxiety symptoms and the strong feelings of anxiety.
- End anxiety symptoms.
- Successfully address the underlying factors that so often cause issues with anxiety.
- End what can feel like out-of-control worry.
All our recommended anxiety therapists have had anxiety disorder and overcame it. Their personal experience with anxiety disorder and their Master's Degree and above professional training give them insight other therapists don't have.
If you want to achieve lasting success over anxiety disorder, any one of our recommended therapists would be a good choice.
Working with an experienced anxiety disorder therapist is the most effective way to treat anxiety disorder, especially if you have persistent symptoms and difficulty containing anxious behavior, such as worry.[11][12][13]
In many cases, working with an experienced therapist is the only way to overcome stubborn anxiety.
Research has shown that therapy is the most effective treatment for anxiety disorder, and distance therapy (via phone or the Internet) is equally, if not more effective, than face-to-face in-person therapy.[14][15][16]
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Additional Comments
Because this symptom is similar to those caused by MS (or other neurological medical condition), many people worry that MS is causing this symptom rather than stress, including the stress caused by anxious behavior. And because MS can cause these types of symptoms, it’s wise to talk with a doctor about this symptom to ensure a medical cause is ruled out.
But if you’ve done that and your doctor has ruled out MS (or other neurological medical condition), you can be assured that stress can cause the sensations associated with this symptom.
I (Jim Folk) had this symptom extensively throughout my struggle with anxiety disorder, and even now and then when I let my stress elevate higher than I normally let it. This symptom is a common symptom associated with anxiety and hyperstimulation.
Common Anxiety Symptoms
Additional Resources
- For a comprehensive list of Anxiety Disorders Symptoms Signs, Types, Causes, Diagnosis, and Treatment.
- Anxiety and panic attacks symptoms can be powerful experiences. Find out what they are and how to stop them.
- How to stop an anxiety attack and panic.
- Free online anxiety tests to screen for anxiety. Two minute tests with instant results. Such as:
- Anxiety 101 is a summarized description of anxiety, anxiety disorder, and how to overcome it.
Return to our anxiety disorders signs and symptoms page.
anxietycentre.com: Information, support, and therapy for anxiety disorder and its symptoms, including the tingling, tingly, prickly, pins and needles anxiety symptoms.
References
1. Chu, Brianna, et al. “Physiology, Stress Reaction.” StatPearls, 7 May 2024.
2. Godoy, Livea, et al. "A Comprehensive Overview on Stress Neurobiology: Basic Concepts and Clinical Implications." Frontiers In Behavioral Neuroscience, 3, July 2018.
3. Elbers, Jorina, et al. "Wired for Threat: Clinical Features of Nervous System Dysregulation in 80 Children." Pediatric Neurology, Dec 2018.
4. 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.
5. 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.
6. 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.
7. Nicolaides, Nicolas, et al. "Stress, the stress system and the role of glucocorticoids." Neuroimmunomodulation, 2015.
8. 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.
9. 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.
10. “Vitamin B12 Deficiency: Causes, Symptoms, and Treatment.” WebMD, WebMD, July 2019.
11. 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.
12. Leichsenring, Falk. “Is Cognitive Behavioral Therapy the Gold Standard for Psychotherapy?” JAMA, American Medical Association, 10 Oct. 2017.
13. DISCLAIMER: Because each body is somewhat chemically unique, and because each person will have a unique mix of symptoms and underlying factors, recovery results may vary. Variances can occur for many reasons, including due to the severity of the condition, the ability of the person to apply the recovery concepts, and the commitment to making behavioral change.
14. Kingston, Dawn.“Advantages of E-Therapy Over Conventional Therapy.” Psychology Today, Sussex Publishers, 11 Dec. 2017.
15. Markowitz, John, et al. “Psychotherapy at a Distance.” Psychiatry Online, March 2021.
16. Thompson, Ryan Baird, "Psychology at a Distance: Examining the Efficacy of Online Therapy" (2016). University Honors Theses. Paper 285.