Numb, tingling feet: why it matters and what to check.

Tingling gets noticed. Numbness is easier to miss, because it is the absence of a feeling. When the two show up together in the feet, it is worth paying attention. This article covers what the National Institutes of Health, the NHS, and MedlinePlus say about why numbness matters, the common causes, and how to look after numb feet.

Why numbness matters

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) explains the main risk: “If peripheral neuropathy causes you to lose feeling in your feet, you may not notice pressure or injuries that lead to blisters and sores.” NIDDK adds that diabetes can make those wounds slower to close and more likely to become infected.

Numbness can also affect balance. The National Institute of Neurological Disorders and Stroke (NINDS) lists loss of position sense among the symptoms of peripheral neuropathy, which can make it hard to coordinate walking or keep your balance with your eyes closed. NIDDK notes that peripheral neuropathy can make you more likely to lose your balance and fall.

Common causes

NINDS, the NHS, and MedlinePlus list these among the common causes:

• Staying in one position too long, or pressure on a nerve
• Peripheral neuropathy. The NHS names diabetes as the most common cause.
• Vitamin imbalances. NINDS: “Vitamin B12 deficiency and excess vitamin B6 are the best-known vitamin-related causes.”
• Alcohol, exposure to toxins, and some medications
• Pressure on spinal nerves, such as from a herniated disk
• Poor blood flow
• Other conditions, including an underactive thyroid

For a fuller list, see Tingling in your feet: common causes and when to see a doctor.

How doctors check the feeling in your feet

NIDDK describes a foot exam that includes a tuning fork placed against the big toe to check whether you can feel vibration, and a nylon strand touched to the foot to check whether you can feel it, called a monofilament test. Your doctor may also check whether you can feel temperature changes. NINDS adds that blood tests can show whether diabetes, a vitamin deficiency, or a liver or kidney problem is involved.

Looking after numb feet

• Check your feet every day for cuts, blisters, or sores. NIDDK advises a daily check if you have diabetes.
• Protect numb areas from cuts, burns, and other injuries, since you may not feel them. MedlinePlus also notes that people with long-term foot numbness may benefit from regular visits to a foot specialist (podiatrist).
• Take off your socks and shoes in the exam room. NIDDK suggests this as a reminder for your doctor to check your feet at every visit.

When to see a doctor

The NHS advises seeing a doctor if you notice early signs such as pain, tingling, or loss of sensation in the feet, or a cut or ulcer on your foot that is not getting better. MedlinePlus advises contacting your provider if numbness or tingling has no obvious cause or gets worse when you walk.

Get emergency care right away if numbness or tingling comes with weakness or trouble moving, follows a head, neck, or back injury, or comes with loss of bladder or bowel control, confusion, slurred speech, or vision changes.

Sources

• National Institute of Diabetes and Digestive and Kidney Diseases, “Peripheral Neuropathy”
• National Institute of Neurological Disorders and Stroke, “Peripheral Neuropathy”
• NHS, “Peripheral neuropathy”
• MedlinePlus, “Numbness and tingling”