A tingling feeling in the back is commonly described as a pins-and-needles, stinging, or “crawling” sensation. Depending on its cause and location, the feeling can be chronic or short-lived (acute). Seek immediate medical attention if the tingling is accompanied by:

  • sudden weakness in the legs
  • problems walking
  • loss of control of your bladder or bowels

Those symptoms in addition to a tingling back sensation could signal a more serious condition called massive disk herniation (cauda equina syndrome) or a tumor on the spine.

Tingling in the back is commonly caused by nerve compression, damage, or irritation. Some causes include:

Brachial plexopathy

The brachial plexus is a group of nerves in the spinal column that send signals to the shoulders, arms, and hands. If these nerves are stretched or compressed, a stinging, tingling pain can develop. In most cases, the pain is felt in the arm and lasts only briefly. But the stinging can radiate around the neck and shoulders. Treatment involves:

Fibromyalgia

Fibromyalgia is a disorder of the central nervous system that produces widespread muscle pain and fatigue. Pain, ranging from dull and achy to tingly, is often worse in areas where there’s a lot of movement, such as the shoulders and neck. The condition is often treated with:

  • pain relievers
  • anti-inflammatories
  • muscle relaxers
  • antidepressants, which can help relieve pain and some of the depression that typically accompanies fibromyalgia

Cervical radiculopathy

Cervical radiculopathy is a pinched nerve that occurs in the spine within the neck. A neck nerve can become pinched (or compressed) when one of the shock-absorbing discs that lies between each vertebra (the bones of the spine) collapses, bulges, or “herniates,” pressing against sensitive nerves. This often happens due to aging or improper body mechanics.

In addition to arm numbness and weakness, there can also be a tingling pain in the shoulder and neck. Most cases will heal with:

  • rest
  • use of a neck collar to limit range of motion
  • over-the-counter pain relievers
  • physical therapy

Lhermitte’s sign

Lhermitte’s sign is a shock-like sensation associated with multiple sclerosis (MS), a neurological disorder. According to the Multiple Sclerosis Association of America, about 40 percent of people with MS experience Lhermitte’s sign, particularly when the neck flexes forward.

The pain usually lasts only seconds but can recur. There’s no specific treatment for Lhermitte’s sign, although steroid use and pain relievers are common treatments for MS.

Shingles

Shingles is an infection caused by the same virus that produces chickenpox (varicella zoster virus). It affects nerve endings. Once you’ve had chickenpox, the virus can lie dormant in your system for dozens of years. If it becomes reactivated, it appears as a blistering rash that often wraps around the torso producing a tingling or burning pain. Treatment includes:

  • pain relievers (including narcotics in some cases)
  • antiviral medications
  • anticonvulsants
  • steroids
  • numbing topical sprays, creams or gels
  • antidepressants

Herniated disc

While a disc can be herniated anywhere along the spine, the lower back is a common site. Treatment consists of:

  • rest
  • ice
  • pain relievers
  • physical therapy

Spinal stenosis

Spinal stenosis is a narrowing of the spinal column. This narrowing can entrap and pinch nerve roots. According to the American College of Rheumatology, it’s a result of osteoarthritis and becomes more common as people age. Anyone over age 50 is at risk. Like other forms of arthritis, it’s treated with:

  • pain relievers
  • anti-inflammatories
  • muscle relaxers
  • steroids

Sciatica

The sciatic nerve runs from the lower back into the buttocks and legs. When the nerve is compressed, which can happen with spinal stenosis or a herniated disc, a tingling pain can be felt well into the legs. To relieve pain, your doctor may prescribe:

  • anti-inflammatories
  • pain relievers
  • muscle relaxers
  • antidepressants

In addition to seeking medical treatment, try some of the following therapies:

Cold and hot compress

Wrap ice in a towel and place it against the painful area for 20 minutes at a time, several times a day. Use ice until the inflammation subsides, then add heat if you find it comfortable.

Rest

Rest up, but don’t take to your bed for more than a day or two to prevent stiffened muscles. Sleep in a fetal position to take pressure off the spine.

Over-the-counter medication

Take pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil) as directed.

Good posture

Stand with your shoulders back, chin up, and stomach tucked in.

Bath

Take a tepid bath with an over-the-counter oatmeal preparation to soothe tingly skin.

Yoga

According research published in the Journal of Orthopedic Rheumatology that analyzed several studies on yoga and back pain, those who performed yoga had less pain, disability, and depression when it came to their lower backs than those who didn’t do yoga. Talk to your doctor for specific recommendations.

Acupuncture

Research collected by the National Center for Complementary and Integrative Health suggests that acupuncture is an effective therapy for relieving low-back pain. To reduce your risk of side effects, see an experienced acupuncturist.

Massage

At least one study shows that when it comes to chronic back pain, deep tissue massage may be more beneficial than therapeutic massage. One caveat: While massage may feel good, its pain-relieving effects are generally short-term.

See a doctor whenever your pain is excessive or persistent, or impacting your daily activities for more than a few days. Other signs you need medical help include:

  • back pain accompanied by a fever, stiff neck, or headache
  • increasing numbness or weakness in your arms or legs
  • problems balancing
  • loss of control over your bladder or bowels

A tingling sensation in your back can have a variety of causes, many of which have to do with nerve compression and miscommunication between the nervous system and brain. Rest, pain relievers, anti-inflammatories, and physical therapy are standard and effective treatments.

In severe cases your doctor may recommend narcotics or surgery to relieve pressure on pinched nerves. While many nerve problems are due to aging and degenerative disc disease, you can help keep your back healthy by exercising, maintaining a healthy weight, practicing good body mechanics, and quitting smoking, because the nicotine in cigarettes can interfere with blood flow, making it more likely you will encounter disc degeneration.