Numbness & Tingling

Numbness and tingling - the medical term is paresthesia - are among the most unsettling symptoms a person can experience. The sensation of a limb “falling asleep,” pins and needles crawling across the skin, or a patch of complete numbness where there should be feeling signals that a nerve somewhere in the body is not functioning properly. While an occasional episode of numbness from sitting in an awkward position is harmless, persistent or recurring paresthesia indicates nerve compression or damage that demands professional evaluation. At Georgia Injury Network, Dr. Daniel Dierdorff identifies the location and cause of nerve compromise and delivers chiropractic treatment that restores normal nerve function.

What Causes Numbness and Tingling

Nerves carry sensory information from every surface and structure in the body back to the brain. When a nerve is compressed, stretched, chemically irritated, or deprived of blood supply, its ability to transmit these signals is disrupted. The result is altered sensation - tingling, burning, prickling, or complete numbness - in the area that nerve supplies.

The key diagnostic question is: where along the nerve’s path is the compression occurring? A nerve can be compromised at any point from where it exits the spine to where it terminates in the fingers or toes.

Spinal Nerve Root Compression

The most common cause of extremity numbness and tingling is compression of a nerve root as it exits the spinal column. Herniated discs, bone spurs, foraminal stenosis, and vertebral misalignment can all narrow the space through which nerve roots pass, producing symptoms that follow the distribution of the affected nerve.

In the cervical spine, nerve root compression typically produces numbness and tingling in the shoulder, arm, forearm, or specific fingers - depending on which nerve level is affected. In the lumbar spine, compression creates symptoms in the buttock, thigh, calf, or foot. The pattern of numbness serves as a roadmap that tells Dr. Dierdorff exactly which spinal level to examine.

Peripheral Nerve Entrapment

Nerves can also be compressed at sites outside the spine where they pass through narrow anatomical tunnels or between muscles:

• Carpal tunnel - the median nerve is compressed at the wrist, producing numbness in the thumb, index, middle, and half of the ring finger
• Cubital tunnel - the ulnar nerve is compressed at the inner elbow, creating numbness in the ring and little fingers
• Thoracic outlet - the brachial plexus is compressed between the scalene muscles in the neck or beneath the clavicle, producing diffuse arm and hand numbness
• Tarsal tunnel - the tibial nerve is compressed at the inner ankle, causing numbness and tingling on the sole of the foot
• Piriformis entrapment - the sciatic nerve is compressed by the piriformis muscle in the buttock, producing numbness and tingling down the leg

Double Crush Syndrome

In many cases, a nerve is mildly compressed at two separate locations simultaneously - for example, a cervical disc herniation and carpal tunnel compression affecting the same nerve. Neither compression alone would be severe enough to produce symptoms, but together they exceed the nerve’s tolerance. This “double crush” phenomenon explains why some patients fail to improve after isolated treatment at a single site and is a key reason why comprehensive evaluation of the entire nerve pathway is essential.

Why You Should Not Ignore Numbness and Tingling

Mild, intermittent paresthesia is easy to dismiss. A tingling hand is less alarming than a sharp pain, and many patients tolerate it for months or years before seeking care. But persistent nerve compression produces progressive damage. What begins as tingling advances to numbness, numbness advances to weakness, and weakness - if the compression continues long enough - can become permanent nerve damage with irreversible motor and sensory deficits.

The timeline for this progression varies by individual, but the principle is consistent: the earlier nerve compression is identified and corrected, the more completely the nerve recovers. Nerves that have been compressed for a short period typically regain full function. Nerves compressed for months or years may recover only partially, even after the compression is relieved.

Diagnostic Approach

Dr. Dierdorff’s evaluation of numbness and tingling follows the nerve from the spine to the extremity, testing at each potential compression site to identify where the problem exists. The examination includes:

• Dermatomal mapping - determining exactly which areas are numb or tingling to identify the involved nerve and nerve root level
• Spinal examination - assessing vertebral alignment, disc integrity, and foraminal patency through orthopedic and neurological testing
• Peripheral nerve testing - provocative maneuvers at each known entrapment site (Phalen’s test for carpal tunnel, Tinel’s sign at the cubital tunnel, the Roos test for thoracic outlet syndrome)
• Muscle strength testing - identifying weakness patterns that confirm which nerve is affected and the severity of compression
• Reflex testing - diminished reflexes indicate the level of nerve root involvement

Treatment

Spinal Decompression

When nerve root compression at the spine is the primary cause, chiropractic adjustments restore vertebral alignment and widen the neural foramen. For disc-related compression, flexion-distraction and decompression techniques reduce disc protrusion and relieve pressure on the nerve root. Patients typically notice improvement in numbness and tingling within the first few weeks of treatment as nerve inflammation subsides and signal transmission normalizes.

Peripheral Entrapment Release

When compression occurs at a peripheral site, treatment targets the specific structures creating the entrapment. Soft tissue techniques release tight muscles and fascia, joint mobilization restores normal mechanics at the elbow, wrist, or ankle, and ergonomic modifications reduce the repetitive stresses that created the entrapment.

Nerve Gliding Exercises

Nerve gliding (or neural flossing) exercises gently mobilize the nerve within its pathway, breaking adhesions and restoring the nerve’s ability to slide freely through the tunnels and tissues it traverses. These exercises are a critical component of recovery for both spinal and peripheral nerve compression.

Do Not Wait for Numbness to Become Permanent

If you are experiencing persistent numbness or tingling in your hands, feet, arms, or legs, your nerves are asking for help. Contact Georgia Injury Network at (470) 397-1527 or schedule your evaluation online. Dr. Dierdorff serves patients throughout College Park, East Point, Hapeville, and the south Atlanta corridor, and early intervention is the key to full nerve recovery.