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Tinglimg, pricky sensation in fingertips , no diabetic. Cause?

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I have tingling in my fingertips and toes for the last 30 days or so. They're like ice-pin pricks, like when your arm or leg falls asleep and is getting blood into it again. Just not as bad. The prickly sensations come and go, not constant. It is noticably stronger when I type on keyboard or otherwise apply some kind of pressure on fingertips.

What could this be due to? I don't have diabetes or any traumatic experience lately. I do have Hepatitis B, although my viral count has been zero for a couple of years old patientand liver enzymes are relatively normal. Could it be liver issues?

Category: Neurologist, Medical

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Category: Pediatric Neurologist
 27 Doctors Online

Thank you for posting your query at
I have noted your symptoms and they are suggestive of small fiber peripheral neuropathy, a disease of nerves located in the skin. This can be confirmed by doing nerve conduction studies.
The next step would be to determine the underlying cause of peripheral neuropathy, which would require blood tests such as serum vitamin B12 level, ANA profile, etc.
Initial treatment consists of pregabalin or gabapentin capsules, which would relieve the symptoms.
Best wishes,
Dr. Sudhir Kumar MD (Medicine), DM (Neurology)
Senior Consultant Neurologist

Patient replied :

Is there any way to heal this condition?

Thank you for getting back.
Initial treatment consists of pregabalin or gabapentin capsules. These would help reduce the severity of symptoms.
Once the cause of neuropathy is established, appropriate treatment can be given to heal the condition.
Best wishes

Patient replied :

The symptoms aren't that bad. Most of the time I don' feel any tingling. I'm posting here to see if I can find the cause.

My medical history consists of Hepatitis B, but with zero viral count and normal enzyme levels. I have read that liver inflammation can cause this peripheral neuropathy. I am due to see my gastro doctor and see if an ultrasound of the liver is needed.

I am not diabetic, but I have been diagnosed with a pre-diabetic condition. However, I don't think my condition is bad enough to cause diabetic neuropathy. What do you think, doctor?

Also, I had been tested for heavy metals and I came out with a higher level of platinum, arsenic, and lead. Not really high, but elevated above normal range a little. I am getting tested for heavy metals again after 3 months. Do you think heavy metals could be the cause of this peripheral neuropathy?

Finally, my peripheral neuropathy has been with me for about 40 days now. It started after I used a medicated pad for muscle pain. Not Salonpas, but a similar product from China. I put it on all night. I only used it one time. I had experienced systemic joint pain and tingling in my fingertips ever since. The joing pain went away, but the tingling remains. I saw a rheumatologist/internist and he said the pad may have dried me out inside. The pad contains 2.5% dimethal sylilate, 1.5% menthol, and 3% camphor as the active ingredients. I don't know what else it could have had. But my tingling started after I used this product 40 days ago.

Could a slipped or compressed disc in my vertebrae also be a possible cause for he tingling. I did have neck issues and an MRI done months ago did show slightly compressed discs.

Thank you for getting back and providing more information.
Regarding pre-diabetes, it can cause peripheral neuropathy. Neuropathy can be the presenting (first) symptom of diabetes, and it is not necessary that poorly controlled diabetes or long duration diabetes is mandatory to cause peripheral neuropathy.
Arsenic and lead toxicity can both cause peripheral neuropathy, however, lead causes motor neuropathy, resulting in weakness. Arsenic toxicity may cause sensory neuropathy.
Hepatitis B infection is UNLIKELY to cause diabetes in your case, as significant liver damage is needed to cause any nerve damage.
Regarding the medicated pad, I am not sure, as I have no prior experience with that.
Best wishes,
Dr. Sudhir Kumar MD (Medicine), DM (Neurology)
Senior Consultant Neurologist

Patient replied :

I'm pretty sure it's some kind of neurotoxin. And I believe it's from the medicated pad. The toxin is the cause of the liver issues as well as the peripheral neuropathy. I don't think the PN is from the hepatitis B.
I will get the medicated pad analyzed at a forensics lab to see what is exactly in it. In addition to the PN symptoms, I also have been having chills emanating from the top of head and blurred vision, and retinopathy. I also have bone tenderness at right collarbone, to the point that it is painful to the touch, although I never injured it in any way. Whatever it is I ingested, it doing a number on my body. I am waiting for heavy metals blood test results.

Thank you for getting back.
I would agree with your observation that toxin is the most likely cause of neuropathy, and it would be worthwhile getting the pad analysed in a lab. Please keep me informed about the results and your progress.
Regarding toxin-induced neuropathy, the symptoms improve over time, once the source of toxin is removed.
Best wishes

Dr. Sudhir Kumar
Category: Pediatric Neurologist
Senior Residency, Fellowship: DM, Neurology, CMC, Vellore, 2001
Junior Residency: MD, Internal Medicine, CMC, Vellore, 1998
Medical School: MBBS, Christian Medical College, Vellore, 1995
Dr. Sudhir Kumar and 4 other Medical Specialists are ready to help you

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