A very common symptom of multiple sclerosis is numbness, often in the limbs or across the body, but it could be experienced anywhere. Numbness is divided into four categories and ranges from the feeling of pins and needles to a burning sensation. Some people can even experience a complete loss of sensation, but this is rarely the case for someone with multiple sclerosis.
Numbness and other sensory symptoms tend to come and go for most people are usually temporary. Other conditions aside from multiple sclerosis can cause numbness, so individuals experiencing this symptom should contact their doctor to make sure no other condition is involved. When caused by multiple sclerosis, numbness is typically harmless, often producing little or no pain. Medications are not typically prescribed for this condition unless it becomes painful or dysesthetic (pain when skin is touched).
Numbness is divided into four categories, as follows:
Paresthesia – feelings of pins and needles, tingling, buzzing, or crawling sensation
Dysesthesia – a burning sensation along a nerve; changes in perceptions of touch or pressure; nonpainful contact becomes painful
Hyperpathia – increased sensitivity to pain
Anesthesia – complete loss of any sensation, including touch, pain, or temperature; “hypoesthesia” is a reduction in these sensations
The first three types of numbness – paresthesia, dysesthesia, and hyperpathia – are all frequently seen at various times and to various degrees in people with multiple sclerosis. The fourth type, anesthesia, is rarely experienced by someone with multiple sclerosis.
Numbness and other sensory symptoms tend to come and go for most people and usually carry a good prognosis for not becoming permanent. Often, the change in sensation occurs only along a patch of skin or in specific areas, such as one or both hands, arms, or legs.
For someone not yet diagnosed with multiple sclerosis, numbness is not necessarily indicative of the disease. A number of nonspecific conditions and alternative settings can cause similar symptoms of numbness. Among others, these include diabetes, carpal tunnel syndrome, back and neck problems, vitamin deficiencies, anemia, and even tight clothing.
When caused by multiple sclerosis, numbness is typically harmless, often producing little or no pain. Medications are not typically prescribed for this condition unless it becomes painful or dysesthetic (pain when skin is touched). According to some individuals with multiple sclerosis, focusing too much about this symptom can actually increase the sensation of numbness, so most try to ignore the numbness.
Should medication be prescribed, steroids (such as cortisone) can be employed in unusual circumstances to improve the condition by reducing inflammation. This can be particularly helpful if lack of sensitivity has impaired functioning to a point where activities are affected. In general, however, steroids are best avoided whenever possible in order to reserve their use for a more serious medical need.
Niacin (one of the B complex vitamins) sometimes assists with reducing numbness. Neurontin® (gabapentin), Lyrica® (pregabalin), Dilantin® (phenytoin), and Tegretol® (carbamazepine) are antiseizure drugs which may be prescribed for controlling painful burning or electric shock-like sensations.
Other modern anticonvulsants may also be prescribed. Elavil® (amitriptyline) is a tranquilizer and antidepressant that may be effective in reducing numbness. Its list of side effects includes drowsiness; therefore, this medication should only be taken when able to rest or at night before going to bed. Other antidepressants, such as Pamelor® (nortriptyline) or Tofranil® (imipramine), may also be tried.
Despite the drugs mentioned, medications are rarely prescribed for this condition alone, unless numbness and other sensory symptoms are painful or dysesthetic. As with all multiple sclerosis symptoms, a doctor should be contacted about any numbness experienced. This is to not only confirm that the numbness is attributable to multiple sclerosis, but also to see if he or she may want to recommend further investigation or treatment.
Updated in May 2024 by Dr. Barry Hendin, MSAA Chief Medical Officer
