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Generalized tingling and nerve pain, no numbness, chest pain, history of back injury. Related?

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General & Family Physician
Practicing since : 2004
Answered : 1777 Questions
Dear Dr.
Thanks for taking the time to read my question. I'd appreciate your advise.

I am a 31 year old made who suffered a back injury playing badminton in October 2010. I've been in mild/moderate chronic low-back pain since then. The MRI report shows a minor disc bulge in L3-4 and L4-5 sections but the pain has been in control otherwise with exercise.

However, since a few months ago, I've have started consistently experiencing symptoms of tingling, pin-needles and mild nerve pain, pretty much all over the body. The tingling/pin-needles is experienced in the head, face, arms, shoulders, neck, legs, and sometimes even inside the eye! The mild, fleeting nerve pains also occur pretty much everywhere, predominantly in the legs. There is no numbness. These symptoms begin as soon as I sit down on the floor, in my office chair or any chair/sofa at home. Sometimes I also feel an mild outward pressure being exerted from the inside of the top of my head and feel a mild pain in the center of the chest (feels like anxiety). These symptoms alleviate once I stand up and start walking, although I've felt tingling in the head/face even when I stand upright.

Are these symptoms attributable to my back injury from way back? Is it compressed/pinched nerve? It's very distracting and worrisome to experience these symptoms.

Any advise is appreciated.

P.S:I've consulted a Neurologist, Accupunturist, Orthopaedician, and done numerous tests. My D3 and B12 are within the normal range. My brain MRI and evoke potential tests came out with normal results as well.
Posted Wed, 2 May 2012 in Back Pain
Answered by Dr. Chakravarthy Mazumdar 2 hours later

Thank you for sharing your problem with me and thank you for explaining your discomfort in detail.

First of all I would confirm you that your symptoms are not related to L3-4, L4-5 disc bulge as you have pins and needles upto head and face.

And your D3 and B12 are in normal range and MRI brain /evoked potentials are normal.

So it could be definitely something else or are we missing something?

I hope you are not Diabetic and people with Diabetic neuropathy could have symptoms like you have described.

Generally pins and needles are related to nerves and it could be possible to have cervical disc problems affecting your arms and legs.

So it would be good to do a MRI of cervical spine and in your case dynamic MRI ; as you have postural variation of your symptoms.

I suspect you might have a prolapsed disc in your neck or upper thoracic spine which compress the nerves in certain positions.

So MRI is the next step to get the diagnosis.

Hope my suggestions will help you.

I will be available for your further queries if any.

Above answer was peer-reviewed by
Follow-up: Generalized tingling and nerve pain, no numbness, chest pain, history of back injury. Related? 12 hours later

I want to first thank you for taking the time and responding in detail. I cannot emphasize enough how comforting it is for patients to have their problems heard keenly by a doctor and respond with concrete suggestions. I just have a couple follow up questions and then I'll be done.

I will have those MRIs done as soon as I can.

To answer your question, no, I am not diabetic.

You may be correct that these symptoms could be unrelated to the back injury. I say this because, I've also experienced the following in the past (before the back injury):

1) Prominent tingling in the face/head when slight pressure is applied to the temple/side of the face or the back of the ear. I have been unable to sleep with my face rested sideways against the pillow and more frustratingly I've been unable to wear eye-glasses for almost 2 years now (due to which I finally underwent LASIK surgery).

2) I experience acne-like painful bumps in the scalp when I wear glasses or sit for longer durations. This always seems to be accompanied with tingling in the head. I never found a satisfactory explanation for those bumps.

3) Had vertigo-like, mild dizziness in the past.

I definitely think those MRIs will help rule out the causes you mention.

My neurologist in the US came to the conclusion that those painful bumps would indeed be acne thinking that the blood flow to the brain was arrested by the impinging of nerves. But I've worn glasses for 20 years before this and never had these symptoms. In my humble opinion, using topical lotions to treat those acne-like symptoms acne would not be treating the cause.

Although the MRIs you suggest are not done yet and results still unknown, how much would one worry about having a prolapsed disc or any cervical/spine problems. It is treatable with surgery or with an exercise regimen. And will I always be vulnerable to having a relapse again?

Thanks and Warm Regards,
Answered by Dr. Chakravarthy Mazumdar 9 hours later

Thank you for the follow up query.

From the symptoms of your pain in the face, I now begin to think whether all these are part of trigeminal neuralgia which is a painful condition of the nerve supplying the face and portion of scalp or even a variant of migraine or vascular headache.

And those bumps could be associated with the vascular headache resulting in dilated blood vessels.

Do not panic about your neck problem now, its only a screening test to make sure that you are alright.

Above answer was peer-reviewed by
Follow-up: Generalized tingling and nerve pain, no numbness, chest pain, history of back injury. Related? 6 hours later

Trigeminal neuralgia was ruled our as I I don't experience pain symptoms in the face, only tingling. The pain in the upper body is usually restricted to a small band of fleeting (nerve?) pain that runs down my arm or shoulder or wrist; the pain starts immediately when I am sitting in a chair in the upright position.

The painful bumps are confined to the scalp leading my neurologist to believe it is trigeminal nerve paresthesia. I underwent Accupunture but found not relief.

After getting your responses, I started doing a bit of research about prolapsed disc. I read about the sciatic nerve and 'sciatica' seemed to come close enough to explaining the symptoms I experience in the lower body - mild nerve pain along the thighs and legs and tingling. I realized that there are many exercises to manage sciatica and felt good about that.

However I wasn't able to find anything concrete about prominent nerves running through the upper body that could explain the symptoms in the upper body. I hope there are exercises for managing upper body nerve impingement as well.

I will carry out the MRIs as you suggested.

Warm Regards,
Answered by Dr. Chakravarthy Mazumdar 2 hours later

Thanks for writing again.

There are lots of exercises for cervical as well as lumbar disc prolapse conditions and they would really help. You can take help of Physiotherapist for the same.

I will wait for your next MRI.

I hope this answers your query.

Wish you good health.

Above answer was peer-reviewed by
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