pins and needles

hi, i have recently (last four months) have been having pins and needles on the right side of my face and they wont go unless i massage the area. I have also been having quite bad lower back pains aswell , which has made me think whether they are tied in together. im only twenty years old and i find this quite worrying. anybody know what this could be?

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

There are several “common” pain syndromes of the face other than headaches. One is a condition called trigeminal neuralgia. This is a type of pain that comes and goes on one side of the face and is severe and sharp when present. When there is no pain, most people are symptom free. It is in the distribution of the trigeminal nerve, hence its name. The pains are usually on the cheek and jaw regions. Triggers can include washing the face, smoking, talking, brushing teeth, etc. The cause is unknown but the thinking is that it is from compression on this nerve. The diagnosis is largely clinical. MRIs may be obtained to rule out other causes or to attempt to identify a cause for the pain, but these tests are most often normal. Treatment includes medications, such as carbamaezpine, gabapentin, and topiramate, that are used in treating seizures. Many pain medications have indications other than pain treatment. Other options include baclofen or clonazepam. If medical therapy is failed, a referral to a neurosurgeon may be an option for consultation regarding trigeminal nerve decompression or radiofrequency ablation.

Another cause of pain in different locations is secondary to emotional/psychiatric problems related to stress. These are true medical conditions whereby instead of a patient experiencing depression or anxiety, they experience physical symptoms, and once the stress is addressed, the symptoms resolve. Fibromyalagia is another medical condition that leads to whole body pains, and is best treated with medications such as lyrica and neurontin, exercise, and physical therapy.

Lastly, I must mention that multiple sclerosis (MS) must be in the differential. This is only because of your age and the sensory changes in your face.

I recommend that you follow up with your primary care physician.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.