Goosebumps is one of the variants of paresthesia. They occur with myelopathy, polyneuropathy, damage to individual nerves, and some other neurological diseases. Observed with varicose veins, obliterating endarteritis, Raynaud's syndrome, mental disorders, metabolic and endocrine pathologies. The cause of the symptom is determined based on the data of the survey, physical examination, instrumental and laboratory diagnostic techniques. Treatment includes painkillers, vascular agents, hormones, antispasmodics, physical therapy, and sometimes surgery.
Goosebumps are a type of paresthesia. May be short-term or chronic, covering one or more areas (head, torso, arms and legs). More commonly seen in the extremities. Short-term paresthesias are a physiological norm, occur under the influence of external factors, disappear immediately or some time after the cessation of exposure. They can be provoked by an uncomfortable posture (“laying down” an arm or leg).
A similar effect, caused not by compression of the nerve, as in paresthesia, but by the pilomotor reflex, is observed with intense negative or positive emotions, including those caused by listening to music. The latter phenomenon is known as "frisson". With temporary compression of the nerve due to an uncomfortable position of the body, numbness quickly passes, the pain is short-lived. With a pilomotor reflex, neurological symptoms are absent.
For pathological goosebumps against the background of diseases, the presence of concomitant neurological disorders is characteristic. As part of paresthesia, along with goosebumps, tingling and burning are observed. There may be a decrease or loss of sensitivity, muscle weakness, paresis. With a long course of the disease, trophic disorders are often noted: thinning and dryness of the skin, hair loss. In some pathologies, in severe cases, ulcerative defects are formed.
Why goosebumps occur
Myelopathy
They are caused by dystrophic changes in the tissues of the spinal cord against the background of various pathologies. Localization and prevalence of goosebumps and other symptoms are determined by the level and severity of the lesion. Paresthesia can be combined with paresis, paralysis, pelvic disorders. The following myelopathy and the reasons for their development are distinguished:
- Spondylogenic: osteochondrosis, spondylolisthesis, spondylarthrosis, spondylosis, intervertebral hernia (discogenic myelopathy).
- Ischemic: chronic disorders of spinal circulation, thrombosis, atherosclerosis, hemorrhage in the spinal cord.
- Post- traumatic: subluxations, dislocations, compression fractures of the vertebrae, spinal cord injuries.
- Carcinomatous: paraneoplastic syndrome in patients with lung cancer, lymphogranulomatosis, lymphoma, leukemia and other oncological diseases.
- Infectious and inflammatory: Lyme disease, neurosyphilis, neuroAIDS, osteomyelitis, tuberculosis.
- Others: toxic effects, consequences of radiation therapy, complication of lumbar puncture.
Taking into account the mechanism of damage, the most common are compression myelopathy, which can occur against the background of injuries, vascular pathologies, tumors, disc herniations, etc.
"Goose pimples"
Polyneuropathies
Goosebumps often become one of the first symptoms of polyneuropathy, replaced by a decrease or loss of sensitivity in combination with muscle weakness. A symmetrical lesion of the upper and lower extremities according to the type of "socks" and "gloves" is characteristic, followed by the spread of disorders to the proximal sections. Depending on the etiology, the following types of polyneuropathies are distinguished:
- Metabolic: hepatic, uremic, diabetic, polyneuropathy of pregnancy.
- Autoimmune: some vasculitis (for example, nodular panarteritis), Miller-Fisher syndrome, polyneuropathy in paraneoplastic syndrome, including POEMS syndrome.
- Hereditary: Dejerine-Sott syndrome, Charcot-Marie-Tooth amyotrophy, Refsum disease.
- Others: alcoholic, alimentary, infectious-toxic polyneuropathy.
Damage to individual nerve trunks and plexuses
It may be due to trauma, compression of the nerve in a narrow bone canal, or other reasons. With neuropathy of the large occipital nerve, goosebumps are observed in the back of the head. With neuropathy of the cervical plexus, paresthesia from the neck and occiput extends to the shoulder girdle, sometimes to the upper body. For the syndrome of the scalene muscle, burning and tingling in the hand on the side of the lesion are typical.
In patients with proximal paralysis against the background of shoulder plexitis, sensory disorders spread along the outer side of the shoulder and forearm, with distal paralysis - along the inside. In other neuropathies, the localization of goosebumps is determined by the affected nerve:
- Elbow: little finger, part of the ring finger and the hypothenar region.
- Median: half of the palm, part of the fingers.
- Radial: with compression in the armpit - the back surface of the shoulder, the back of the forearm, partially the fingers; when the nerve is involved in the lower third of the shoulder, the upper part of the forearm and in the projection of the wrist - the back of the hand and fingers.
- Ischial: back and outer surface of the lower leg, almost the entire foot.
- External cutaneous nerve of the thigh: external and partially anterior surface of the thigh.
- Femoral: anterointernal part of the lower leg, inner edge of the foot.
- Tibial: posterior tibia, sole, partially toes.
- Fibular: anterolateral part of the lower leg, dorsum of the foot.
Other neurological pathologies
Goosebumps can be the result of traumatic brain injury. Sometimes they occur after neurosurgical operations. Observed in such pathologies as:
- Multiple sclerosis. Manifests weakness in the legs, less often - paresthesia and numbness in different parts of the body. In the future, cerebellar and pyramidal disorders, damage to the cranial nerves, paresis, paralysis are found.
- Guillain-Barré syndrome. In the debut, muscle weakness, goosebumps, burning and numbness of the legs are noted. After a few hours or days, the disorders spread to the hands. In severe cases, tetraplegia and respiratory failure are formed.
- Stroke. Hemiplegia or hemiparesis is associated with sensory disturbances in the affected areas of the body. Nausea, vomiting, cephalgia, impaired consciousness, facial distortion, smoothing of the nasolabial masonry are revealed. Focal symptoms depend on the location of the stroke.
- brain tumors. Goosebumps and other paresthesias are determined by the defeat of the pyramidal system, are observed in 25% of patients. Headaches, vomiting, systemic dizziness, spastic paresis, convulsions, mental disorders are possible.
Goosebumps, itching, pressure, numbness, and tingling are considered constant manifestations of restless leg syndrome. More often occur in the region of both legs, sometimes asymmetric. Worried at night. Over time, they spread to the hips, less often to the lower body. In addition, the symptom is observed in the initial phase of migraine with aura, preceded by some attacks of epilepsy.
Vascular diseases
In patients with varicose veins, goose bumps in the legs, as a rule, appear at the stage of subcompensation or decompensation. Disturbed after a long stay on the legs, combined with a feeling of heaviness, pain, swelling. The symptom is also present in obliterating diseases of the lower extremities: endarteritis, atherosclerosis, thromboangiitis. It occurs already at the initial stage, supplemented by numbness of the fingers, chilliness, fatigue, muscle cramps.
Raynaud's syndrome
Paroxysms in Raynaud's syndrome include goosebumps, numbness, whitening and coldness of the distal extremities, followed by bursting, pain and burning. At first, the attacks last a few minutes, then they can lengthen up to 1 hour. Caused by the following pathological conditions:
- Rheumatic diseases: rheumatoid arthritis, SLE, scleroderma, vasculitis.
- Other pathologies: compression of blood vessels and nerves, damage to sympathetic ganglia, hematological and hormonal problems.
- Repetitive external influences: vibration, cooling.
Other reasons
The cause of goosebumps all over the body or in its individual areas can be:
- infectious diseases. With influenza, SARS and other acute common infections, the symptom is due to severe hyperthermia. With herpes zoster, it is observed in the initial stage, combined with burning and itching along the affected nerves.
- Changes in the endocrine background. Paresthesia may indicate the development of hypoparathyroidism. Convulsive muscle contractions, dyspepsia, deterioration of twilight vision are characteristic. Some women experience goosebumps during PMS, pregnancy, and menopause.
- exchange violations. With hypovitaminosis B1, goosebumps, shortness of breath, palpitations, cardialgia, headache, irritability are noted. With calcium deficiency, symptoms similar to hypoparathyroidism are found. Low magnesium levels are manifested by paresthesias, tremors, nausea, weakness, and loss of appetite.
- Mental disorders. With vegetative-vascular dystonia, goosebumps can appear in any part of the body, complemented by dizziness, palpitations, shortness of breath, disorders of the gastrointestinal tract and other manifestations. With neurasthenia and depression, they are determined against the background of psychological exhaustion and somatization of experiences.
- Taking medication. Sometimes goosebumps occur during treatment with antiepileptic and antihypertensive drugs, isoniazid, ofloxacin, and some other drugs.
Diagnostics
Establishing the nature of the pathology is the responsibility of neurologists. If there are indications, patients are referred for consultations to rheumatologists, phlebologists, vascular surgeons, and other specialists. As part of the survey, the time of the first appearance of goosebumps, the frequency of the symptom, and the presence of other manifestations are established. The examination program provides for the following procedures:
- General inspection. Allows you to detect signs of varicose veins (dilated tortuous veins, pastosity, swelling), trophic disorders (dryness and thinning of the skin, hair loss, skin defects), poor blood supply (weakening or disappearance of pulsation). In obliterating vascular diseases, special functional tests are performed.
- Neurological examination. The specialist assesses muscle strength, checks reflexes. Determines the prevalence and nature of sensory disorders. It reveals paresis, signs of damage to the cerebellum, the pyramidal system, and other disorders that may indicate a pathology that provokes the appearance of goosebumps.
- Electrophysiological studies. Electromyography, electroneurography and evoked potentials are used to diagnose myelopathy, neuropathy, polyneuropathy, and other neurological diseases. They provide an opportunity to clarify the level of damage, the severity of nerve damage.
- visualization techniques. Depending on the suspected disease, an MRI of the spine or brain, X-ray of the spinal column, discography, myelography are prescribed. If vascular pathologies are suspected, dopplerography or duplex scanning of the vessels of the affected area is recommended.
- Other methods. With myelopathy, a lumbar puncture is performed. If amyloid polyneuropathy is suspected, a nerve biopsy is performed. In case of obliterating vascular diseases, capillaroscopy, thermography, and other methods are informative.
- Laboratory tests. The study of cerebrospinal fluid helps to establish the cause of myelopathy, to determine the presence of inflammation or hemorrhage. With the infectious nature of the disease, PCR tests are performed, sowing on nutrient media. To verify autoimmune polyneuropathies, an analysis is carried out for antibodies to GM1-ganglycosides.
Inspection of the skin
Treatment
Conservative therapy
Therapeutic tactics are determined taking into account the cause of the appearance of unusual sensations in the body. The following methods are applied:
- Myelopathy. The presence of an ischemic component is an indication for the appointment of antispasmodics, vasodilators, drugs to improve microcirculation. With infectious etiology, antibiotics are indicated, with toxic - detoxification measures. In all forms, neurometabolites and vitamin preparations are recommended.
- Polyneuropathies. Carry out treatment of the causative pathology. To eliminate the pain syndrome, analgesics, NSAIDs, tricyclic antidepressants are used. As part of symptomatic therapy, B vitamins and neurotrophic agents are used. In some forms of the disease, the introduction of human immunoglobulin, the administration of hormones, and plasmapheresis may be indicated.
- Varicose veins. At the initial stage, phlebotonics, a decrease in static loads, the use of elastic bandages and compression stockings are useful. In the absence of reflux from deep veins to superficial veins, compression sclerotherapy, cryosclerotherapy, Foam-form sclerotherapy are performed.
- Obliterating vascular lesions. You need to quit smoking. Drug treatment will include antiplatelet agents, anticoagulants, NSAIDs, antibiotics, glucocorticoids, antispasmodics. The effectiveness of balneological treatment, hyperbaric oxygenation is noted.
- Raynaud's syndrome. It is necessary to exclude provoking factors, to carry out therapy of a provoking disease. Recommended selective calcium channel blockers, calcium antagonists, ACE inhibitors, antiplatelet agents. Developed seizures are eliminated by warming the limbs, with inefficiency, antispasmodics are administered.
In most diseases with paresthesias in the body, physiotherapeutic measures are indicated. UHF, electrophoresis, electrical stimulation can be used. Sometimes paraffin therapy, galvanization, SMT are effective. Patients are prescribed reflexology, massage, exercise therapy. With a pronounced violation of the function of the limbs, mechanotherapy is practiced.
Surgery
To eliminate paresthesias and other symptoms in the body and limbs, the following operations are performed:
- Myelopathy: removal of hematomas or Urban wedge, drainage of cysts, puncture disc decompression, laminectomy, discectomy, microdiscectomy.
- Varicose veins: phlebectomy, miniphlebectomy, adhesive obliteration, laser coagulation, radiofrequency coagulation, combined interventions.
- Obliterating processes: lumbar or periarterial sympathectomy, thromboembolectomy, dilatation, stenting or prosthesis of the artery, amputation or exarticulation in gangrene.