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Feet Tingling? Doctors Say the Symptom Could Be a Sign of Several Conditions

Prevention 2/9/2023 Lauren Krouse, Madeleine Haase, Amy Capetta
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Tingling in your feet is not usually cause for concern. And when you get that familiar pins-and-needles feeling in your feet or numbness in your toes, typically it’s easy to fix: Reposition yourself to take the pressure off of your nerves, and you’re good to go.

“Tingling in the feet is a very common symptom and usually does not indicate a serious problem,” says William Buxton, M.D., neurologist and director of Neuromuscular and Neurodiagnostic Medicine and Fall Prevention at Pacific Neuroscience Institute at Providence Saint John’s Health Center in Santa Monica, California.

This prickly feeling is known as paresthesia, which is usually a temporary condition caused by a blood flow blockage within the nervous system, according to University of Rochester Medical Center. Once the obstruction is removed (like standing up or uncrossing your legs), tiny electrical impulses in the nerve structures that normally travel around the body (from the spine, arms, legs and brain) start working overtime. As a result, that painful, burning and/or pins-and-needle sensation tends to indicate that the nerves are “waking up.”

However, if you’re still tingling after you untwist your legs, the feeling persists for a long time, or is accompanied by other symptoms like balance problems, weakness, pain, or a change in your vision, something else may be going on. One common diagnosis for that tingling sensation is peripheral neuropathy, a type of nerve damage that affects more than 20 million people in the U.S., reports the National Institutes of Health (NIH). But while neuropathy explains what’s physically happening in your feet, it doesn’t explain the reason behind it.

A nerve condition, vitamin deficiency, or injury might be to blame for tingling in feet. Experts share other common causes for tingling feet, plus when to see a doctor. © Sorrorwoot Chaiyawong / EyeEm - Getty Images A nerve condition, vitamin deficiency, or injury might be to blame for tingling in feet. Experts share other common causes for tingling feet, plus when to see a doctor.

Here, we offer reasons as to why your feet might be buzzing, along with typical ways these certain health conditions are diagnosed and treated.

1. Diabetes

“The number one reason for tingling in the feet in this country is diabetes,” says Oluwatosin Thompson, M.D., a neurologist at the Greater Baltimore Medical Center. Whether you’re at risk of developing diabetes or have had your diagnosis for years, as your blood sugar levels get higher, nerve damage could cause tingling in your feet, explains Dr. Thompson. In fact, according to the NIH, up to half of people living with either type 1 or type 2 diabetes also have peripheral neuropathy.

How it’s diagnosed:

Common symptoms of both type 1 and type 2 diabetes include numbness or tingling in the hands and feet, as well as increased thirst, hunger, urination and fatigue, states the NIH. A blood test ordered by your physician can determine blood glucose levels.

How it’s treated:

Type 2 diabetes can be treated with either oral medicine, insulin and/or dietary changes, while type 1 diabetes is managed with insulin. Managing your blood sugar with lifestyle changes and medication may help reduce your symptoms and prevent further nerve damage, per the National Institute of Neurological Disorders and Stroke.

2. Medicine

Since the majority of prescription medications come with side effects, your medication may be to blame for your tingling feet. Dr. Thompson adds that drugs designed to treat cancer, namely chemotherapy, as well as HIV and AIDS, could lead to this reaction. Other common culprits include medicine for managing high blood pressure, infections, autoimmune diseases, seizures and alcohol use disorder, according to MedlinePlus, a service of the National Library of Medicine.

How it’s treated:

In this case, it’s important to have a discussion with your doctor about whether you should try a different medication with fewer side effects or if the benefits of your treatment outweigh the costs, he says.

3. Pregnancy

As your baby grows, pressure from your uterus can compress nerves in your legs and lead to pins and needles all the way down to your toes. You might also notice numbness and tingling in your hands due to changing fluid levels in your body, notes Dr. Thompson.

How it’s treated:

While annoying, these symptoms are normal—and they should go away after you’ve given birth. However, gentle massage and gentle exercises may help reduce the sensation. If numbness or tingling in your feet is persistent, worsens, or is accompanied by pain or swelling, contact your healthcare provider.

4. B vitamins

“If you’re deficient in B vitamins like vitamin B1 or B12, you can begin to have tingling sensations in your feet, and it usually starts in both of them,” says Dr. Thompson. Your nerves and nerve coverings need these vitamins to function properly, and without them, your feet could begin to tell you you’re low on them.

Interestingly enough, though, too much vitamin B6 can also cause tingling in your feet, says Dr. Thompson.

How it’s diagnosed:

Routine blood work can determine if your body is lacking in any nutrients. Other symptoms that may surface from a vitamin B deficiency include fatigue, shortness of breath, dizziness, irregular heartbeats, muscle weakness and forgetfulness, according to Mayo Clinic.

How it’s treated:

Consult with your doctor before you start taking any dietary supplements—they’ll help you take the correct amount to get your body back in balance. Keep in mind vitamin B12 is mostly found in meat like beef, fish, and chicken, so if you eat a vegetarian or vegan diet, ask your doctor about taking supplements to make sure you’re getting enough.

5. Pinched nerve

“If you have back pain and tingling that shoots down your legs and into your feet, that often points to a pinched nerve in your back,” says Dr. Thompson. You might get a pinched nerve from an injury, pregnancy, arthritis, or stress from repetitive movements at work or the gym.

How it’s diagnosed:

A physical examination where your healthcare provider assesses your reflexes and muscles can help determine if you’re dealing with a pinched nerve, according to Cedars-Sinai. In some cases, imaging tests, like x-ray, CT scan or MRI, could be necessary.

How it’s treated:

Depending on your diagnosis, your doctor may suggest weight loss, physical therapy or medicine, such as nonsteroidal anti-inflammatory drugs (NSAIDs), narcotic medicines for more severe pain and muscle relaxants.

6. Aging spine

Typically, spinal stenosis—or a narrowing of the spaces between your spine which puts pressure on your nerves that could cause tingling in both of your feet—strikes when you’re 50 and up, per the Mayo Clinic. Most of the time, it’s part of the aging process as osteoarthritis wears away at the cartilage that serves as a cushion for your joints. Other symptoms may include pain in the lower back, a heavy feeling in the legs or weakness in the leg or foot, reports the Cleveland Clinic.

How it’s diagnosed:

During a doctor’s visit, your physician may press on different areas of the spine, along with asking you to bend in different directions and walk in order to check your balance, as well as arm and leg strength. Imaging tests, such as x-rays and MRI, may also be prescribed.

How it’s treated:

Medication, physical therapy, and even minimally-invasive surgery can help relieve your symptoms, says Kiran Rajneesh, M.D., a neurologist and pain specialist at the Ohio State University Wexner Medical Center in Columbus.

7. Multiple Sclerosis

Multiple sclerosis, or MS, is a disease that impacts the brain and spinal cord, which make up the central nervous system, according to the National Multiple Sclerosis Society. While tingling or numbing of the legs and arms tend to be the initial symptoms, other common signs include muscle spasms and weakness, as well as experiencing walking, bowel, bladder, vision and/or cognitive issues.

How it’s diagnosed:

While no single exam can confirm a diagnosis, a series of tests, including blood tests, a cranial examination (which checks vision, hearing, facial sensation, strength and swallowing) and balance tests may be given. If necessary, an MRI and a spinal fluid analysis might be recommended in order to exclude other health conditions, states the National MS Society.

How it’s treated:

Even though there is no cure for MS, which is classified as an autoimmune disease, treatments are tailored to help manage symptoms, reduce relapses and slow the progression of the disease, reports the Cleveland Clinic. A treatment plan may include prescription meds, physical therapy and mental health counseling.

8. Hypothyroidism

Also known as an under-active thyroid, hypothyroidism is a condition where the thyroid gland is unable to produce enough thyroid hormones, which helps the body use energy, stay warm and keep the brain, heart, muscles and other organs functioning properly, states the American Thyroid Association. Along with tingling in the feet, other symptoms may include fatigue, depression, constipation, forgetfulness and feeling cold.

How it’s diagnosed:

Since common symptoms overlap with other conditions, a physician may order two types of blood tests: TSH (thyroid-stimulating hormone) test, which measures how much of the thyroid hormone thyroxine (T4) the thyroid gland is being asked to make, and T4 tests, which measure how much T4 is in the blood and available to get into cells.

How it’s treated:

Hormone-based medicine that can help restore the body’s thyroid hormone levels may be prescribed.

9. Chemical exposure

According to the University of Chicago, toxins and poisons can lead to peripheral neuropathy. These chemicals can derive from the environment (such as pollution and/or exposure to lead, mercury or arsenic found in some household products or herbal medicines) or drug abuse. Along with tingling in the feet, pain and numbness may also be present. Other possible symptoms include weakness and difficulty walking.

How it’s diagnosed:

It may take numerous tests to receive a diagnosis. Blood and urine tests are likely to be prescribed, as well as neurological evaluation and an EMG, (an electromyography, which measures the electrical activity of a muscle and detects how well the muscles receive stimulation from the nerves).

How it’s treated:

If the exact toxins have been identified, the treatment plan may include the removal of the chemicals from your surroundings. Over-the-counter or prescription pain medication may also be recommended.

10. Alcohol Use Disorder

Alcoholic neuropathy is a common side effect of alcohol abuse, states the NIH. Tingling, numbness or pain in the feet, as well as in the lower extremities, can be the result of damage to the central and peripheral nervous systems. Studies indicate that up to 66 percent of adults living with alcohol use disorder are affected by this condition.

How it’s diagnosed:

Various tests will likely be conducted in order to determine if alcohol abuse is the culprit, including nerve conduction tests and an EMG (needle electromyography, which records signals from muscle fibers). Other screenings may also be ordered to rule out other conditions, such as diabetes, HIV, vitamin B deficiency and chemical exposure.

How it’s treated:

The treatment for alcohol use disorder may involve prescription medicine, behavioral treatment (such as one-on-one cognitive behavior therapy) and community support groups (such as Alcoholic Anonymous), according to an article published in the journal JAMA.

11. Autoimmune disease

Less commonly, autoimmune disorders such as lupus, Sjogren’s syndrome, Guillain-Barré syndrome, rheumatoid arthritis, and multiple sclerosis can cause tingling in your feet. Here’s why: An overactive immune system can attack the nerves in the body. In other cases, arthritis caused by these conditions pinches the nerves, which can lead to tingling feet, says Dr. Buxton.

How it’s treated:

Autoimmune disorders vary, along with their symptoms and forms of treatment. According to the NIH, the medical community is aware of at least 80 diseases that fall under this category. Other concerning symptoms, like weakness, numbness, difficulty breathing or chronic pain, can help your doctor figure out a proper diagnosis and treatment plan.

12. Tarsal Tunnel Syndrome

Tarsal tunnel syndrome (TTS) is a condition that occurs when you have a damaged or compressed tibial nerve, according to Cleveland Clinic. TTS may be caused by any condition that strains or compresses the tibial nerve, including flat feet or fallen arches, swelling caused by an ankle sprain, or diseases such as arthritis or diabetes [type 1 or type 2], which can cause swelling and nerve compression. according to Johns Hopkins Medicine. This compression of the tibial nerve can lead to pain, tingling or numbness in the foot.

How it’s diagnosed:

To diagnose tarsal tunnel syndrome, your doctor will likely examine your ankle or look for injuries, and use imaging, such as X-rays or MRIs, as well as an electromyogram or EMG, a test that uses an electrical impulse to measure nerve and muscle function. Your doctor may also use a Tinel’s test, where your doctor gently taps your tibial nerve. If you experience pain or tingling that reproduces your symptoms, it may point to TTS.

How it’s treated:

Nonsurgical treatment for TTS includes anti-inflammatory medications or steroid injections into the tarsal tunnel to relieve pressure and swelling. Braces, splints or other orthotic devices may help reduce pressure on the foot and limit movement that could cause compression on the nerve. Depending on the severity of the condition, the doctor may ultimately recommend an operation called tarsal tunnel release, in which the surgeon performs a nerve decompression—also referred to as neurolysis—to relieve pressure from the tibial nerve and allow for proper blood flow.

When to see your doctor about tingling in your feet

If your feet have been tingling for a while, and movement and changing positions doesn’t seem to be relieving any of the pain, your safest bet is to head into your doctor’s office for an evaluation.

Dr. Buxton explains that your physician will likely ask expect a few questions about your symptoms (like such as where you’re tingling and how long it’s been going on), plus along with giving you a physical exam to check on your reflexes, balance and ability to feel sensations, like light touch and vibration. Depending on your results, you may also need additional blood tests, imaging exams like X-rays and MRIs, or specialized nerve and muscle tests to identify what’s causing the tingling.

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