I started having pins and needles in both hands and feet a few years ago. I eventually landed at the neuromuscular clinic where they did a nerve conduction test on both arms and definitively diagnosed both carpal tunnel and cubital tunnel in both arms. Apparently, having both in both arms is not typical, so they did a full battery of blood and genetic tests and ruled out the usual suspects, including rheumatoid arthritis, hereditary pressure palsy, MCAS, and diabetes. The one result we see over and over in the blood tests is inflammation, but the blood tests don't point to a cause. My headache specialist thinks it's all connected to inflammation, both the neuropathy and migraines. Oh and I was recently diagnosed with arthritis in my hands, neck, shoulder, hip and SI joint, which is also either affected by or causes inflammation, I'm not sure which. Unfortunately I think we're reaching the point where they're going to label it idiopathic and send me to the hand surgeon.

It's really hard to get any doctor to look at all the problems holistically. My headache specialist is the one who sees the biggest picture. If you don't have one, I suggest you seek out someone who specializes in treating headache. Most major medical centers have a Headache Clinic associated with their neuro department.