What causes pins and needles?

Altered nerve function somewhere along the path from the spinal cord to the skin. That could be irritation of a nerve root at the spine, compression somewhere along the limb, or a medical cause unrelated to mechanics — diabetes, thyroid disease and B12 deficiency all produce this pattern. Where it is felt usually narrows it down considerably.

When should I be worried about numbness?

Seek urgent care for numbness that comes on suddenly, affects one whole side, involves the face, comes with weakness, slurred speech or visual change, or sits around the groin and inner thighs with any bladder or bowel change. Those are medical emergencies rather than musculoskeletal problems.

Can chiropractic help pins and needles?

Where the cause is mechanical irritation of a nerve — a nerve root at the spine, or compression along the limb's path — then often yes. Where the cause is metabolic, medication-related or systemic, it will not, and you need a GP. Working out which you have is the point of the examination.

Why do my hands go numb at night?

A common pattern with carpal tunnel syndrome, where the median nerve is compressed at the wrist, and also seen with nerve irritation at the neck. The distribution matters: carpal tunnel typically spares the little finger, while a cervical nerve root follows a different map. That distinction is straightforward to test.

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Get urgent medical care if

Numbness comes on suddenly, affects one whole side of the body, involves the face, or arrives with weakness, slurred speech, confusion or visual change — these can indicate a stroke. Also urgent: numbness around the groin, buttocks or inner thighs, particularly with any change in bladder or bowel control. Call 000 or go to an emergency department. Do not book an appointment and wait.

Where the interference can happen

A nerve runs a long way from the spinal cord to the skin, and it can be irritated at any point along it.

At the nerve root. Where the nerve exits the spine — commonly from a disc or from narrowing of the exit canal. Symptoms follow a specific map: particular fingers, or a defined band down the leg. In the leg this often presents as sciatica.
Along the limb. Carpal tunnel at the wrist, cubital tunnel at the elbow, or compression through the shoulder region. The distribution differs from a nerve root pattern, and the two are distinguishable on examination.
Neither. Diabetes, thyroid disease, B12 deficiency, certain medications and other systemic causes all produce numbness and tingling, and they typically do it in a glove-and-stocking distribution affecting both sides. That pattern is a strong signal to see a GP rather than a chiropractor.

Why the distribution matters so much

It is the single most informative piece of information you can bring. Numbness in the thumb, index and middle fingers that spares the little finger points strongly towards the wrist. Numbness in the little finger and the ring finger points towards the elbow or the lower cervical spine. A band down the outside of the calf into the top of the foot suggests a particular lumbar level.

Before you come in, it is worth paying attention to exactly where it is and exactly when: at night, at the desk, after walking a certain distance. Those details narrow the field quickly.

How we assess it

The examination is properly neurological: reflexes, power testing, sensation mapped across dermatomes, and specific nerve tension and compression tests. Alongside that, a segmental assessment of the spine and the relevant limb joints.

The purpose is to establish whether this is mechanical nerve irritation we can address, and if so, where. Where imaging would change the plan, we have it on-site.

What care might involve

Where the cause is mechanical: adjustment of segments that have lost movement, soft tissue work along the nerve's path, cold laser therapy for irritability, spinal decompression for particular disc-related presentations, and rehabilitation to change the loading pattern behind it.

And where it is not mechanical

If the examination points to a metabolic, systemic or medication-related cause, chiropractic care is not the answer and we will say so. You will get a clear explanation and a recommendation to see your GP, which is a considerably better outcome than a course of treatment that was never going to work.

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