Tingling in your feet: common causes and when to see a doctor.

Tingling in the feet can be a foot that fell asleep, or it can be an early sign of nerve damage worth checking. This guide covers what the National Institutes of Health and MedlinePlus say about the common causes, why the feet are often affected first, how doctors find the cause, and when to get help.

What tingling is

MedlinePlus describes numbness and tingling as abnormal sensations that can happen anywhere in the body but are most often felt in the fingers, hands, feet, arms, or legs. People describe it as prickling, buzzing, or “pins and needles.”

Tingling that passes and tingling that keeps coming back

Tingling after sitting with your legs crossed, or after any long stretch in one position, is among the common causes MedlinePlus lists. Tingling that keeps returning without a clear reason is different. The National Institute of Neurological Disorders and Stroke (NINDS) notes that nerve symptoms “may develop over days, weeks, or years.”

Common causes

NINDS and MedlinePlus list these among the common causes:

• Pressure on a nerve, or staying in one position too long
• Peripheral neuropathy. NINDS calls diabetes “the leading cause of peripheral neuropathy in the U.S.”
• 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
• Infections such as shingles
• Poor blood flow
• Other conditions, including an underactive thyroid and multiple sclerosis

Why the feet are often affected first

NINDS explains that most neuropathies are “length-dependent,” meaning the nerve endings farthest from the brain “(those in the feet) are where the symptoms develop first or are worse.” NINDS also notes that about two thirds of people with diabetes have nerve problems that “can cause numb, tingling, or burning feet.” The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) puts peripheral neuropathy at up to one-half of people with diabetes.

If your tingling is worse at night, see Why do my feet tingle at night?

How doctors find the cause

NINDS says diagnosis usually starts with a history: your symptoms and what makes them better or worse, your work, habits, and alcohol use, exposure to toxins, and family history. A physical and neurological exam checks your sense of touch, vibration, and temperature. Blood tests can show whether diabetes, a vitamin deficiency, or a liver or kidney problem is involved.

NIDDK describes the foot exam used in diabetes care, which includes a tuning fork against the big toe to check whether you can feel vibration, and a nylon strand touched to the foot, called a monofilament test.

Protecting numb feet

Numb feet can miss small injuries. MedlinePlus advises protecting numb areas from cuts, burns, and other injuries, and notes that people with long-term foot numbness may benefit from regular visits to a foot specialist (podiatrist). NIDDK advises people with diabetes to check their feet for problems every day.

When to get help

MedlinePlus advises contacting your health care provider if numbness or tingling has no obvious cause, if leg numbness or tingling gets worse when you walk, or if it comes with other unusual symptoms.

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.

MedlinePlus also cautions against stopping or changing medicines, or taking large doses of vitamins or supplements, without talking to your provider first.

Sources

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