This has happened to me since I was in high school, but I think for many years didn’t recur. Lately, I am noticing it more. When I take an deep involuntary breath or sigh, at the point I finish my exhalation there is a little pinprick inside the end of fingertop, somewhat like a static shock. I Googled this question and it appears to be totally normal (I’m not worried, I assume it is) but happens to many people without explanation. No, it’s not anxiety-related paresthesia or a nerve disorder. (If it were anxiety it would be pervasive (whole hand) and persistent.) I’m 25 and in good shape. I’m just looking for a physical/biological explanation for this. If the best thing people can come up with is a wishy-washy CO2/O2 imbalance thing that’s just a guess, that would be dissatisfying.
[Disclaimer]
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I am not your doctor.
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I am not any sort of physician at all.
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The only thing I know of your symptoms is the limited description you have mentioned here on an anonymous internet message board.
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I am merely blindly speculating at what could be–but probably isn’t–causing these sensations.
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The “pinprick” and “electric shock-like” feelings you describe are not totally dissimilar to some sensations sometimes reported by some people with multiple sclerosis.
To anyone who spots this thread: I am absolutely NOT looking for medical advice. Simply a vexing question that seems to happen to lots of people posted for students of physiology who are willing to engage in speculation or have seen a relevant piece of literature.
Why do you say it isn’t a nerve disorder? If you feel something happen at your fingertip when nothing is actually going on there, by definition that IS a nerve disorder, isn’t it? Your nerves are erroneously reporting that something happens there. Nerves behaving in an orderly way only report real events.
My guess would be that your body movement, particularly in the neighborhood where your thoracic and cervical vertebrae meet, is moving nerve roots around a little.
The tingling you describe is a sort of “paresthesia”. The fact that you associate it with sighing and deep involuntary breathing makes one wonder about chronic hyperventilation syndrome. In hyperventilation, either acute or chronic, the blowing off of CO2 causes the blood to be less acidic (“respiratory alkalosis”) and that causes a host of other electrolytes to shift around, including the blood level of calcium decreasing which can cause a tingling sensation or even involuntary spasms of the hand muscles, due to the effect of low blood calcium levels on peripheral nerve function. I suggest consideration of chronic hyperventilation because it seems unlikely that a single or even a small series of sighs alone would do that unless there was a background level of deep sighs occurring.
(Obviously this is intended as part of a general abstract discussion of your op description as a hypothetical and not specific to you.)
When I said it was not anxiety-related or a C02/02 imbalance I thought that would preclude hyperventilation, which it most definitely is not. I recognize what hyperventilation is and when I’m doing it. Sighing is not usually a feature of hyperventilation anyway. Rapid shallow breathing and frequent yawning are, none of which includes sighing. Nor do I think this is what people are describing on Yahoo! answers, etc. Regardless of what “seems unlikely” I think I’m making myself pretty clear about what I and others are describing.
Read what you respond to much?
I don’t know if you have chronic hyperventilation or not and am clearly not in a position to diagnose or to explain your particular experience but in terms of the hypothetical case presented and that information alone chronic hyperventilation fits the description less poorly than any other explanation. And the explanation of tingling with deeper than usual sighs in that scenario is as offered up by this student of physiology who is willing to engage in speculation.
OH, btw, there are some accepted ways to pretty much confirm the diagnosis when it is suspected. The first is to check arterial levels of CO2 (pCO2) on multiple occasions - consistently lower than normal levels at rest are diagnostic. Less invasively CO2 can be measured by a probe in the nose at the end of respiration - testing that and respiratory rate changes (or lack thereof) during change in position from laying flat to standing up (orthostasis) can be diagnostic. Another method, albeit one with less specificity, is to have the subject intentionally hyperventilate; if intentional hyperventilation at rest reproduces the symptoms, such as paresthesias (a presenting sign in over a third of those with chronic hyperventilation, rarely whole hand and never persistent), then the diagnosis is considered confirmed by many if not most sources.
The need to make the diagnosis is in the context of someone who otherwise may be subject to a host of invasive testing, beyond ruling out the major causes of chest pain when that is how it presents. Since you are sure that “it most definitely is not” chronic hyperventilation, and are also very sure that it is “totally normal” then that need may not apply. But I don’t know you or your specifics so again take this only as a comment on the presentation as a hypothetical and not as specific to you.
Thanks for the info, but I remember this occurring well back into junior high school. I suffered from GAD and chronic AD and recognize hyperventilation - even in others, and I thought I hid it well. I know very well that my AD set on in early college; in retrospect the sequence of events is all too obvious. By persistent I meant as long as hyperventilation persists, and I can easily attest to thorough numbness of the hands up to the wrist (to the point where they fumble rather than grasp objects), not to mention the front of the face, including cheeks, forehead and chin. The kicker for me is the other posters on the internet who seem to present no anxiety or symptoms of hyperventilation, which are readily apparent to someone who has experience them. I didn’t mention this, but it seems to happen rather more frequently when I’m fatigued. I had hoped someone might think of a study or come across something that addressed this (seemingly) not uncommon phenomenon specifically. Failing that, I can say that I expected disappointment and have found it.
Well, then, as your doctor, I advise you to go out and find a real doctor who does this on a for pay basis, and approach getting your diagnosis that way.
I agree with DSeid’s comments here, from a standard medical perspective.
While I wouldn’t comment on your exact situation, if I were to see a patient who described their history and symptoms using the language you do, I would be inclined to suspect they will have a lifetime of disappointment with the standard medical profession.
Have you considered seeking the advice of a homeopath? Were I to have a patient seek my (standard, medical) counsel with the descriptions you’ve provided, I think that’s where I’d point her.
I’ve been following this thread for a while but have refrained from posting my ‘speculation’ because that’s really all it is - speculation. So, I’ll probably regret this, but here goes:
When you exhale after a deep breath, it’s possible that there is some very minor, and very brief, irritation of one of the nerves involved in breathing. Perhaps some kinking, or at least a sudden release of tension in its sheath that may (somehow) irritate the nerve (I said it was speculation).
The diaphragm (main breathing muscle) is innervated by the Phrenic nerve which comes from cervical roots 3, 4, and 5 (i.e. C3, C4, C5). So, irritation of the phrenic nerve can cause sensations to be felt in those areas of the body which get their sensory supply from C3, C4, or C5. In fact, those roots, especially C5, provide sensation for the shoulder (and upper arm) and, therefore, hopefully it’s no surprise that people with irritation of the diaphragm and/or phrenic nerve often report pain in their shoulder. But, alas, you report pain in your fingertip (which one(s) by the way). So, this particular speculation seems to be at a dead end.
The other major muscle groups used in breathing are the intercostal muscles. The first intercostal muscle is innervated by T1. Well, T1 sometimes provides sensation to the little finger. So, perhaps, possibly, when you exhale a deep breath, you’re doing something to T1 and you feel it in your little finger. Obviously, this is untenable if you note the sensation in, say, your thumb (where do you feel it?; in which fingertips?).
There you go. My speculation. Not too convincing, I admit.
Hey, KarlGauss, a slight hijack - can C5 root problems influence breathing problems?
I’m more inclined to the obscure on this question, which is why the overly obvious and unlikely hyperventilation angle vexes me so much. If it is a nervous disorder of the kind you describe, alas, I am in no position to evaluate it. The sensation occurs in the four fingers opposed to thumb, by the way, and never the thumb. I didn’t mean to take a tone with anyone, but I do recognize that anonymous posters on an internet message board “are not [my] doctor” (I went to college). Furthermore I was never looking for a “diagnosis” so much as a plausible explanation for a very real phenomenon.
From a top Google hit:
What she says about the involuntary aspect is true for me as well. Don’t know what her primary complaint is, and I’m not interested.
Again, Tingling in Hands When You Exhale? - Tinnitus Support Message Board
I also notice that if I make a controlled exhale after the sigh (obviously I am now growing very attuned to the progression) slowly through the mouth the feeling does not occur. I can tell it would happen though with a comparatively swift exhalation through the nostrils. It’s just too damn bad I’m hyper-observational by nature rather than just shrugging my shoulders and forgetting about things.
The other galling thing is that I’m NOT interested in finding a diagnosis for a question that seems on a par with “Why does my ass itch sometimes?” A poster on another message board related a story in which their doctor shrugged his shoulders, and I’m not even interested in posing the question to a doctor. I just thought the crack posters on Straight Dope might say, Oh, yes, that’s likely caused by [insert technical terminology here that I’ll try to make sense of through Wikipedia.]
I’m no expert, so take my answer with a big grain of salt.
Since C5 is one of the roots contributing to the phrenic nerve, and since the phrenic nerve controls the diaphragm, then, yes, a C5 root problem may have an effect on breathing. However, the phrenic also gets major input from C3 and C4 and that should be enough to allow for ongoing function of the phrenic nerve and, thus, the diaphragm.
It probably also depends on the nature of the “lesion” at C5. Many lesions are associated with swelling (edema) and thus can functionally extend beyond the level of the lesion per se. In particular, edema originating at C5 as a result of a lesion there, would likely lead to some diaphragmatic paralysis, albeit temporary (i.e. only so long as the edema was present).
jsmaine22,
I can’t quite understand what you are trying to demonstrate with your links. That tingling with deep sighs is not an infrequent occurrence, especially among those with chronic medical problems like MS and tinnitus? And? Indeed, chronic hyperventilation is common, usually cited at about 10% of the general medicine clinic population. A small minority have acute hyperventialtion; most have the underlaying basis as frequent sighing that they are not even aware of, even if family and friends notice it. Chronic hyperventilation is subtle. Your op was not about you but about this common phenomenon of overbreathing causing tingling and you have been given an answer about that. Your reaction is that because you have had acute hyperventilation in the past and have a past history of anxiety disorder that you most assuredly do not have chronic hyperventilation. Fine. Whatever. The answer wasn’t about you anyway. The answer to the general question about this not uncommon event however remains that deep sighs can, in the presence of chronic or even acute hyperventilation, change the acid-base balance of the body. The effects of that altered acid-base balance include reducing free calcium ions in the blood stream which increases the excitability of peripheral nerve axons, which therefore spontaneously fire, which is felt as a tingle. Some sizable minority of people with hyperventilation can also have some resulting decreased blood flow to the brain as a result and can have some neurological signs as a result of that. Anxiety disorder and panic disorder are sometimes associated with both the chronic disordered breathing pattern and with acute hyperventilation but are not the same as the syndrome. A fair percentage of people with the syndrome indeed have something organic to be anxious about.
That is the answer as to how deep sighs cause a tingling sensation in a fair number of people as a GQ. Whether or not it applies to you (apparently you think you can’t have chronic hyperventilation because you have had acute hyperventilation and anxiety disorder in the past) is not the question asked or answered.
You don’t want to hear that answer, for whatever reason. Also fine.
Karl, sensation of the hand is generally C6-8, diaphragm motion is unlikely to affect the symptoms related to those nerves, and if it did it would be greater with the greater excursion of the diaphragm with exercise (whereas exercise does not cause symptoms in those with hyperventilation as the cause). Good thought though and I thought you’d find this article to be of interest. Brachial plexus injury occurs on occasion with difficult vaginal deliveries. Most recover well, some need PT/OT, some have residual problems. This an odd one - the nerves grow back from the injury but cross over some so the arm moves (slightly) with breathing.
Thank you so much! That is fascinating (and is ever so slightly along the lines of what I was trying to intuit in the current ‘case’).
Again, much obliged for your efforts to dig that up.