Systemic Lupus Erythematosus (SLE) is a chronic autoimmune condition where the body’s immune system mistakenly attacks healthy tissues and organs. This systemic disease can affect nearly any part of the body, including the nervous system. Lupus does cause numbness, and this common symptom can arise from several distinct mechanisms related to nerve damage or restricted blood flow. Understanding how lupus impacts sensation is important for effective management.
How Lupus Affects Peripheral Nerves
Lupus frequently causes numbness and tingling by damaging the peripheral nervous system, which includes all the nerves outside the brain and spinal cord. This condition is known as peripheral neuropathy. The most frequent cause of this nerve damage is chronic inflammation attacking the nerves or the small blood vessels that supply them.
The inflammation may involve vasculitis, where blood vessel walls become damaged, restricting the flow of oxygen and nutrients to the nerve fibers. When nerves are starved of blood, their function is impaired, leading to abnormal sensations. This often results in a symmetrical pattern of numbness and tingling, commonly beginning in the hands and feet, described as a “stocking and glove” distribution. Symptoms can range from a prickling sensation to burning pain and muscle weakness.
Raynaud’s Phenomenon: A Specific Cause of Hand and Foot Numbness
A separate, temporary cause of numbness in lupus patients is Raynaud’s phenomenon, a common co-occurring condition. This vascular issue involves an exaggerated constriction of the small arteries supplying blood to the fingers and toes. This vasospasm is typically triggered by exposure to cold temperatures or emotional stress.
During an episode, the lack of blood flow causes the affected digits to blanch white, then often turn blue due to oxygen deprivation. This reduced circulation leads directly to a temporary feeling of numbness and tingling, sometimes accompanied by pain. As the spasm resolves and blood flow returns, the digits may turn red and feel warm, with a throbbing sensation.
Central Nervous System Involvement and Sensation Changes
Lupus can also affect the central nervous system (CNS), which includes the brain and spinal cord, resulting in a range of sensory changes. When lupus involves the CNS, it is referred to as Neuropsychiatric SLE (NPSLE). Inflammation and damage within the brain or spinal cord can disrupt the pathways that transmit sensory information, leading to altered sensation or numbness.
Numbness resulting from CNS involvement might be less localized than peripheral neuropathy and often appears alongside other symptoms. For example, inflammation of the spinal cord, known as transverse myelitis, can cause numbness and weakness in the limbs. Diffuse involvement, such as inflammation or stroke-like events in the brain, can also manifest as sensory disturbances, often accompanied by cognitive changes or severe headaches.
Monitoring Symptoms and Treatment Approaches
Careful documentation of numbness symptoms is important, as it helps doctors determine the underlying cause. Patients should note the specific location, the duration, and any triggers for the numbness, such as cold exposure or stress. Communicating a sudden onset of severe numbness, especially if accompanied by weakness or paralysis, is important, as this could indicate a serious event like a stroke or transverse myelitis.
Treatment is focused on controlling the systemic inflammation of lupus to protect the nervous system. Immunosuppressive medications, such as corticosteroids and other drugs that regulate the immune system, are often used to reduce the autoimmune attack that causes nerve damage. For the numbness itself, specific medications like anti-seizure drugs or certain antidepressants may be prescribed to calm nerve signals and manage pain.
Managing Raynaud’s phenomenon involves avoiding triggers, such as wearing warm clothing and protecting the hands from cold environments. If lifestyle adjustments are not enough, doctors may prescribe medications that relax blood vessels to improve circulation. A rheumatologist or neurologist will often work together to develop a comprehensive plan that addresses both the underlying lupus activity and the specific neurological symptoms.