Does Alcohol Withdrawal Cause Pins needles?

Robert Gerchalk

Robert is our health care professional reviewer of this website. He worked for many years in mental health and substance abuse facilities in Florida, as well as in home health (medical and psychiatric), and took care of people with medical and addictions problems at The Johns Hopkins Hospital in Baltimore. He has a nursing and business/technology degrees from The Johns Hopkins University.

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Alcohol Withdrawal and Its Unpleasant Symptoms

Aside from poor diet, sedentary lifestyle, and tobacco products, alcoholism or alcohol-related fatalities are a leading cause of preventable death across the country, according to the Centers for Disease Control. Alcohol addiction is often conversationally called alcoholism, but the healthcare community labels it alcohol use disorder. If you are suffering from this condition, your body may suffer damage in your immune system, liver, pancreas, mouth, brain, and heart. Quitting drinking is possible, but you have to go through a detoxification process known as alcohol withdrawal. That can involve many unpleasant symptoms, and the condition called “pins and needles” is one possibility you might have to deal with.

Detoxification and Pins and Needles

Alcohol withdrawal often triggers a variety of symptoms, and they range from mild and uncomfortable to seriously unpleasant and even dangerous or life threatening. Specific symptoms can include physical manifestations, such as sweating and shaking. However, mental states might come about in the form of depression or heightened anxiety. Many of these symptoms of alcohol withdrawal are somewhat expected by drinkers, but one side effect that sometimes happens does catch people off guard. That symptom is the pins and needles sensation that can happen during detoxification.

Going through alcohol withdrawal can activate your body’s fight-or-flight response mechanism, and that results in all kinds of nervous system changes. One of them is the onset of a condition known as peripheral neuropathy. This condition happens when nerves are damaged and stop functioning properly. The primary symptom of this condition is the physical sensation known as pins and needles. Most of the time, peripheral neuropathy is a temporary condition. Yet, it can turn into a permanent condition in some instances. If your alcohol withdrawal includes the pins and needles sensation, then you should see your primary care physician. They need to ensure there aren’t other causes behind it, but they can also offer you proper treatment.

Pins and needles often happen because the nervous system is overloaded. This can happen after heavy drinking because consuming high volumes of alcohol can make the human body increase the production of cortisol, which is a stress hormone. That’s what overloads the nervous system. Pins and needles can indicate more serious issues, including delirium tremens or seizures; both of those conditions are serious and can threaten your life if they happen while you’re undergoing alcohol withdrawal. Should you experience any of these serious symptoms, then you might need to detox safely in a hospital or dedicated medical facility.

Alcoholic Neuropathy

Individuals who drink excessively might start feeling tingling and pain in their limbs. That’s because alcohol is often toxic to the human nervous system and its tissues. The name for this condition is alcoholic neuropathy. Individuals afflicted with this condition have peripheral nerves that are overly damaged by excessive consumption of alcohol. The peripheral nerves communicate signals between the brain, spinal cord, and the rest of the human body. For the nervous system to function properly, it needs sufficient levels of niacin, folate, thiamine, and vitamins B6, B12, and E. If you drink too much, you can impact the nutrient levels in your body can impact how alcoholic neuropathy spreads. The good news is that abstinence from alcohol might restore nutritional balance in your body. Symptoms can improve, and future nerve damage might be preventable. Unfortunately, some nerve damage from alcohol winds up being permanent.

Alcoholic neuropathy can impact both physical sensation and movement. The symptoms can be just slightly uncomfortable or ramp up to serious disability. The condition isn’t generally life-threatening, but it can reduce your quality of daily life. The specific impacts it has varies based on the part of your body that alcoholic neuropathy impacts. Pins and needles are often associated with the limbs, and your arms and legs might demonstrate movement disorders, loss of muscle function, weakness, atrophy, cramps, spasms, numbness, tingling, burning, and prickly sensations. Bowel and urinary indications can include urination difficulties, diarrhea, constipation, incontinence, and the feeling that your bladder isn’t completely empty. Other general symptoms include dizziness, feeling lightheaded, vomiting, nausea, trouble swallowing, heat intolerance after exercise, sexual dysfunction, impotence, and impaired speech. 

Consult a healthcare professional if you exhibit any of these symptoms. Proper diagnosis and treatment, especially early, give you a higher chance of recovery. For a doctor to accurately diagnose this condition, you need to be honest about your personal history of consuming alcohol. Testing can help rule out other possible symptom causes, and it might start with testing the functions of your liver, thyroid, and kidneys. Lab testing might also work up a complete blood count. Your doctor might order a nerve biopsy, nerve conduction test, electromyography, EGD, and an upper GI and small bowel series. Neurological examinations are used alongside blood tests that study potential vitamin deficiencies.

The primary factor involved with treatment for alcoholic neuropathy is to quit drinking. That might mean inpatient rehab, but social support programs and outpatient therapy can help some alcoholics quit. After the addiction itself is addressed, your doctor might work directly on the neuropathy. Managing symptoms is crucial since nerve damage can impact your daily life and make physical injuries more likely. Options might include vitamin supplements, pain relievers, physical therapy, safety gear, and orthopedic appliances. Nerve damage might be permanent. However, the sooner you quit drinking and address the problem, the better your future outcome will be.


While you might be able to conjure up the mental image of someone having a seizure, you might not know what one is. The definition is a burst of uncontrolled electrical activity in the human body that results in temporary abnormalities of different kinds. This uncontrolled electrical activity happens between brain cells known as neurons, and the temporary abnormalities can be changes in movement or muscle tone resulting in limpness, twitching, or stiffness. Other potential abnormalities include temporarily altered awareness, sensations, or behaviors. Not all seizures are the same. One might be a single event resulting from an acute cause, but recurring seizures might be epilepsy. If you exhibit symptoms of seizures during alcohol withdrawal, you need your doctor to diagnose it to see if other issues might be causing it before deciding on treatment.

Delirium Tremens

The condition called delirium tremens is also known as alcohol withdrawal delirium or just DTs. Regardless of the specific name you or your healthcare professional might use, it’s a serious kind of alcohol withdrawal. When it starts, it’s usually two or three days after someone dependent on alcohol stops their long binge. DTs typically last 48 to 72 hours, but symptoms might linger for up to a week. Fortunately, only around 5% of individuals going through alcohol withdrawal wind up developing delirium tremens. Unfortunately, delirium tremens that are left untreated can result in stroke, heart attack, and death. 

The depressant nature of alcohol slows the human nervous system and brain, so stopping drinking suddenly after long stretches of alcohol consumption is a change that nerve cells don’t adapt to very quickly. The resulting overstimulation might result in a spike in the production of the glutamate amino acid, and that chemical can be responsible for DT symptoms, including seizures, tremors, high levels of excitability, and severely high blood pressure. DTs are more common among heavy drinkers, long-term drinkers, individuals who have detoxed before, people who have a history of having seizures, and adult men, particularly younger, white, and unmarried men.

The Process of Alcohol Withdrawal

If you are an alcoholic, then two truths are likely happening to you. First, you have developed a clinical tolerance for alcoholic beverages. Second, you are physically dependent on it. Both of these characteristics of alcohol use disorder develop over a long period as your alcohol use is both chronic and increasing in level. Tolerance and physical alcohol dependence both make it more likely that you’ll go through uncomfortable and potentially dangerous symptoms when you stop using the substance or reduce your consumption to a serious degree. 

Alcohol withdrawal syndrome is the acute onset of this set of symptoms in your earliest stages of abstinence. Many people find this detoxification process incredibly uncomfortable and even painful, but it’s also a necessary start to your long-term recovery. Clinical tolerance is the concept of how much alcohol your body needs before you start feeling highly intoxicated, and it rises as you consume more alcohol. Physical dependence happens as your tolerance goes up. Your body needs increasing levels of alcohol to not only react to its presence but to even function in a normal fashion. Without alcohol, you might have difficulty sleeping, focusing, or managing your emotions. Withdrawal from alcohol usually happens in three stages.

The first stage of alcohol withdrawal syndrome often sees the initial symptoms start within eight hours following your final drink. Serious cases might have symptoms even show up after just six hours. Mild symptoms in stage one include depression, heart palpitations, nausea, vomiting, and mood swings. Moderate symptoms can include brain fog, high heart rate, severe shaking, brain fog, and sensations of itchiness and tingling in your legs and feet. Serious symptoms might include pins and needles, tunnel vision, profuse sweating, dry heaves, and an inability to sleep.

The second stage of alcohol withdrawal typically starts 24 hours after your last drink of alcohol. This stage can last two or three days, and the intensity levels are variable. Mild symptoms of this stage might include anxiety, feeling lightheaded, difficulty sleeping, sweating, and obsessive thoughts about alcohol. Moderate symptoms include shakiness, minor hallucinations, mood swings, fever, and indigestion. Severe symptoms might cause the hallucinations to start involving multiple senses, and you might have vivid dreams, nightmares, seizures, and confusion. Delirium tremens might start at this point. Medical assistance might include sleep medications and IV treatment for dehydration.

The third stage of alcohol withdrawal sometimes means things start improving with symptoms easing and the mind getting less foggy. Still, other individuals might start seeing symptoms that jeopardize their lives in ways that didn’t happen in the first two stages. DTs involve anxiety, disorientation, hallucinations, and tremors, and they’re sometimes called “the shakes” because of all this. Physical symptoms should start subsiding in or after the third stage, but psychological symptoms need more time to fade. Those include irritability, depression, anxiety, and obsessive thoughts regarding cravings and urges for alcohol.

Continuing Treatment After Withdrawal

Any recovery from alcoholism has to start with the process of physical detoxification, but physically ridding your body of the substance is rarely enough to make sure you don’t start drinking again in the future. Inpatient rehab is also called residential treatment, and it’s a place where you can start your recovery under medical supervision and access individual counseling, group therapy, or a combination of both. This is a time when you can put distance between alcohol and yourself before heading back into the world. 

Sober living facilities are another option where you have more personal freedom, but you can still develop and practice the skills you need to lead an alcohol-free life. Outpatient programs continue counseling on a personal basis or in a group setting, and you keep learning relapse prevention skills and how to face the challenges of your early recovery. Continued support might include 12-step groups and a variety of recovery activities, and these can keep going for however long you feel you need additional support. Some alcoholics accept their recoveries as a lifelong commitment.

You’re Not Alone

Many people drink alcohol on a social basis or just occasionally, and you might feel alone in your struggle with alcohol use disorder if you’re surrounded by drinkers who aren’t addicted. If you’re ready to change and want help, we can provide that. As recovering alcoholics ourselves, we know what you’re going through, and we’re here to provide reliable resources to you free of charge. We’ve created our Alcohol Awareness website and alcohol hotline to help anyone with questions about their conditions, and we can connect you to healthcare professionals with expertise in alcoholism, recovery from addiction, and mental health conditions. Call us anytime toll free at 885-955-0771 to get started.