There are many reasons for numbness and tingling in the feet. Sometimes the cause originates in the feet and other times it a systemic cause meaning there is a disease process in the body that manifests in the feet. The number one cause of burning/numbness/tingling/pins and needles sensation in the foot in the US is diabetes. Other common causes are alcoholism, vitamin B12 deficiency, hypothyroidism, HIV, and multiple sclerosis. Occasionally patients have “idiopathic peripheral neuropathy” which means there is no clear cause for the burning, numbness or tingling in their feet. Systemic causes usually result in burning, tingling or numbness in BOTH feet and often in a symmetric distribution (like the toes, ball of the foot, or entire bottom surface). A systemic cause of nerve sensations frequently occurs while at rest, especially in the evening and can even wake you from sleep.
If the burning or tingling sensation is in just one foot or leg, you may have a compressed nerve in the lower back (specifically L4, L5, S1). When the problem is higher up then treating the foot is only for symptomatic relief and the problem is not truly being addressed. If you have a known back problem (compressed vertebrae, slipped disc, etc), it is important to inform your podiatrist during your appointment.
Sometimes tight shoes (especially laced shoes) can cause numbness in the foot, particularly during exercise when our feet swell. Occasionally patients have a bone spur on top of the foot in an unfortunate position where the nerve is pinched between the bone and shoes. This can be relieved by skipping eyelets in the shoe so the laces do not contact that area of the foot, applying a pad around (but not on) the spur, or surgically removing the spur.
If you are going to see a podiatrist for burning or numbness in the feet, it is important for you to take note of when you have the sensations (with activity or while at rest, with or without shoes), specifically where the sensations occur and what gives you relief. The more detailed you can be, the better the chance for accurate diagnosis and optimal treatmen
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