Electric Shock Feeling in Your Feet or Hands: Could It Be Neuropathy?

Electric shock sensations in your feet, legs, or hands usually come from irritated or damaged nerves. Doctors call this neuropathic pain, and peripheral neuropathy is one of the most common reasons for it. A compressed nerve or a problem in the spinal cord can feel the same way, so finding the cause takes an evaluation. [1]

Neuropathic pain is more common than most people expect. A systematic review put the best estimate for pain with neuropathic features in the general population at 6.9 to 10 percent. [2] The shock-like quality matters to doctors, too. "Electric shocks" is one of the descriptors on the DN4 questionnaire, a screening tool for neuropathic pain. [3]

What causes electric shock sensations?

When nerves are damaged or compressed, they can fire signals on their own, without any real trigger. Patients describe this spontaneous pain as burning, pricking, or squeezing, and sometimes as a shock. [1] The most common sources are:

• Peripheral neuropathy. Damage to the nerves in the feet and hands, often tied to blood sugar problems or low vitamin B12. These are among the first things neurologists check. [4]

• Small fiber neuropathy. Damage to the thinnest nerve fibers, which carry pain and temperature signals. Burning pain in the feet is the most common symptom, and no cause is found in up to half of cases. [5]

• A compressed nerve. Pressure on a nerve at the wrist, as in carpal tunnel syndrome, or on a nerve root in the spine can send shock-like signals along the nerve. [1]

• Lhermitte's sign. An electric shock sensation that runs down the spine, sometimes into the arms or legs, when you bend your neck forward. It is strongly linked to multiple sclerosis. [6]

The last item deserves a closer look. In one study of 694 people with multiple sclerosis, about 16 percent had Lhermitte's sign, and most of them had a lesion in the cervical spinal cord on MRI. [7] The sign is a symptom, not a diagnosis, and it needs a medical explanation whenever it appears.

Questions that help narrow it down

Where the shocks happen offers clues. Shocks in both feet at once tend to suggest a problem affecting many nerves, as in peripheral neuropathy. Shocks along one arm or leg tend to suggest a single compressed nerve. Shocks that come when you bend your neck point toward the cervical spine or spinal cord. These patterns are clues, not a diagnosis.

Your neurologist will also ask when the sensations started, what makes them better or worse, and whether you have numbness, weakness, or balance problems. A list of your medications and your alcohol use helps too, because both can affect nerves.

When to see a neurologist

See a doctor if the sensations keep coming back, spread, or interfere with sleep or daily activities. Weakness, balance problems, or numbness alongside the shocks make an evaluation more urgent. Sudden weakness, loss of bladder or bowel control, or numbness after an injury needs emergency care.

Keep a short log of when the shocks occur and what you were doing. It helps your neurologist spot patterns. Many causes can be treated, and early care gives nerves a better chance to recover. Our post on whether neuropathy can be reversed explains how much that depends on the cause.

How neurologists find the cause

The evaluation starts with a neurological exam that checks strength, reflexes, sensation, and balance. Blood tests come next. The ones most likely to find an abnormality in people with neuropathy are blood glucose, vitamin B12 with its related markers, and serum protein immunofixation electrophoresis. [4]

Nerve conduction studies and EMG measure how well signals travel through your nerves and muscles. They mostly test the larger nerve fibers, so results are typically normal when only the small fibers are affected. [8] When small fiber neuropathy is suspected, a skin biopsy that counts nerve endings, quantitative sensory testing, or autonomic testing can help. [5] Imaging of the spine or brain may be added when your symptoms suggest a compressed nerve root or multiple sclerosis.

What treatment involves

Treatment depends on the cause. Correcting a problem such as high blood sugar or low vitamin B12 may protect nerves from further damage, and treating an underlying cause often calms the shocks. How much improvement to expect depends on the cause and how long the nerve has been affected.

Several classes of medicine also target the abnormal nerve signaling behind neuropathic pain. Your neurologist chooses among them based on the cause, your other health conditions, and how you respond. [1] Stress can make nerve pain feel worse, though it is not a cause of neuropathy, as we explain in our post on stress and neuropathy.

References

[1] Finnerup NB, Kuner R, Jensen TS. Neuropathic pain: from mechanisms to treatment. Physiol Rev. 2021;101(1):259-301. https://doi.org/10.1152/physrev.00045.2019

[2] van Hecke O, Austin SK, Khan RA, Smith BH, Torrance N. Neuropathic pain in the general population: a systematic review of epidemiological studies. Pain. 2014;155(4):654-662. https://doi.org/10.1016/j.pain.2013.11.013

[3] Bouhassira D, Attal N, Alchaar H, et al. Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4). Pain. 2005;114(1):29-36. https://doi.org/10.1016/j.pain.2004.12.010

[4] England JD, Gronseth GS, Franklin G, et al. Practice parameter: evaluation of distal symmetric polyneuropathy: role of laboratory and genetic testing (an evidence-based review). Neurology. 2009;72(2):185-192. https://doi.org/10.1212/01.wnl.0000336370.51010.a1

[5] Terkelsen AJ, Karlsson P, Lauria G, Freeman R, Finnerup NB, Jensen TS. The diagnostic challenge of small fibre neuropathy: clinical presentations, evaluations, and causes. Lancet Neurol. 2017;16(11):934-944. https://doi.org/10.1016/S1474-4422(17)30329-0

[6] Al-Araji AH, Oger J. Reappraisal of Lhermitte's sign in multiple sclerosis. Mult Scler. 2005;11(4):398-402. https://doi.org/10.1191/1352458505ms1177oa

[7] Beckmann Y, Ozakbas S, Bulbul NG, et al. Reassessment of Lhermitte's sign in multiple sclerosis. Acta Neurol Belg. 2015;115(4):605-608. https://doi.org/10.1007/s13760-015-0466-4

[8] Devigili G, Rinaldo S, Lombardi R, et al. Diagnostic criteria for small fibre neuropathy in clinical practice and research. Brain. 2019;142(12):3728-3736. https://doi.org/10.1093/brain/awz333

Neurology Associates Neuroscience Center evaluates and treats peripheral neuropathy at our Chandler and Mesa clinics. Contact us to schedule an appointment.

IMPORTANT NOTE: This blog post is for informational purposes only and not medical advice. Always consult a qualified healthcare provider for diagnosis or treatment decisions regarding neuropathy or any other neurological condition. Do not rely on this content as a substitute for professional medical guidance.