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Foot & Ankle

Numb Toes May be Indicative of an Underlying Condition

By Last updated on July 14th, 2022July 14th, 2022No Comments

Everyone has experienced the sensation of numbness when an appendage “falls asleep”. There is numbness, tingling, and sometimes pain.

But what happens when this sensation does not go away?

Chronic numbness can significantly impact the quality of life and mobility. Numbness of the foot can lead to problems with walking or standing.

Anatomy of the Foot

The foot is comprised of many structures, including bones, muscles, tendons, cartilage, and nerves, to name a few. Each structure plays an important role in the foot’s day-to-day ability to function and support the rest of the body.

One of the main nerves that affect the foot is called the peroneal nerve, which runs from the bottom of the spine into the toes. Nerves located outside of the spinal cord and brain are called peripheral nerves. When damage occurs to these nerves, it is called peripheral neuropathy.

Numbness of the foot is commonly attributed to nerve damage or poor circulation, but there are many reasons why nerves and blood veins do not act as they should. Nerves and veins can become compressed on their way to the foot. Some potential causes of numbness or tingling in the foot include:

  • Swelling
  • Improper footwear
  • Peripheral neuropathy
  • Injury to the foot
  • Diabetes
  • Vascular disease

If numbness and tingling begin to interfere with daily life consult a doctor. Diagnosing numbness can lead to proper treatment of the issue and relief of symptoms.

Diagnosing Numbness of the Foot

Diagnosing Numbness of the Foot

Doctors will begin an examination by asking questions in an attempt to locate the cause. It is important to be completely honest with them during this phase, as certain symptoms that may not seem relevant could be crucial information. These questions may seek information about diet, fitness level, type of employment, previous injury, smoking status, and so on.

Symptoms may vary, so it is important to describe each symptom in as much detail as possible. Some symptoms that may occur with numbness are:

  • Inability to feel hot or cold
  • Tingling sensation (“pins and needles”)
  • Sharp, shooting pain
  • Inability to move the foot or toes

These symptoms may occur constantly or only in certain positions. Some symptoms may occur at random. Though some conditions can heal on their own, when symptoms begin to interfere with daily life it is time to consult a medical professional.

Once a doctor has received as much information as possible from the patient, they may perform a physical examination of the foot or feet. The physical examination may include watching the patient walk, touching certain areas, and asking how it feels, among other exercises. 

Once the physical examination has occurred, doctors may order further testing to occur so that they can be certain of the cause. These may include:

  • Electromyography: this imaging technique measures the electrical activity in muscles while they are active and at rest. The results of an EMG can indicate if there is an issue with muscles or nerves and if there is an issue with the signaling between muscles and nerves.
  • Nerve conduction studies: an electrical impulse is sent through the nerves and measured to determine how long a nerve takes to transmit the electricity. If a signal takes an abnormal length of time, it may be indicative of neuropathy.
  • Magnetic Resonance Imaging (MRI): this popular imaging technique can produce an image of soft tissues. In the case of numb toes, it could indicate that a nerve is being compressed, and reveal what is causing the compression. Issues relating to circulation (rather than issues with the nerves) may use an MRI to observe the blood vessels.
  • Biopsy: doctors may take a sample of nerve fibers to examine. A skin biopsy is a minimally invasive procedure that takes a piece of skin for observation. A nerve biopsy is an invasive procedure that takes a sample directly from the nerve inside the body.

Some doctors may also order blood tests or other scans to determine the underlying cause. Once a proper diagnosis has been made, doctors can begin to formulate a treatment plan. Treatment options can vary based on the diagnosis and the patient’s individual needs.

Treating Numbness

Each condition associated with numbness has a different treatment plan, but there are some steps that most individuals can take to alleviate symptoms. Many individuals can alleviate symptoms by keeping their feet warm or changing footwear. Some may need to change their exercise routine to prevent stress on the legs and feet.

Treatment of numb toes and feet seeks to reduce symptoms and restore mobility. Some common methods are:

  • Physical therapy: certain exercises can help muscles gain mobility. Some conditions can cause muscle atrophy, a condition caused when lack of use leads muscles to begin wasting away. Exercising the muscles regularly can relieve symptoms of atrophy and prevent it in the future.
  • Pain relief: some over-the-counter pain relief can be useful for individuals attempting to rehabilitate the area. If pain is severe, doctors may prescribe medication. Prescription pain relievers can be dangerous, so it is important to review all of the side effects and risks before taking them.
  • Orthopedic equipment: certain corrective gear such as braces, shoes, socks, and splints can help relieve pressure on the affected nerve.
  • Corticosteroid injections: this form of injection can reduce swelling, so it may help relieve symptoms if a nerve is compressed. Repeated use of corticosteroid injections can damage soft tissue over time, however, so they should be closely monitored by a medical professional.
  • Surgery: surgical procedures may vary depending on the patient’s condition. If other treatments fail to relieve symptoms, surgery may become an option. Some procedures seek to relieve pressure on the nerves by addressing the cause. If numbness is being caused by an abnormality of the bone either in the spine or legs, surgeons may be able to change the shape of the bone.

Treating numbness in the toes and foot can take a long time, as nerves take longer to heal than other structures such as muscle. For example, muscles can begin to heal in a matter of weeks but nerves can take several months.

It is important to note that some nerve damage may be permanent, depending on the cause of the numbness. Some conditions such as diabetic neuropathy and frostbite can damage nerves beyond the point of repair. If nerves have been damaged completely, treatment begins to focus heavily on managing symptoms and making lifestyle adjustments if mobility is impacted.

Though conventional treatments may be successful for some individuals, it is important to consider all available options. Alternative treatments like regenerative therapy could alleviate symptoms and prevent further damage from occurring.

Dr. Matthew HC Otten

Director of Regenerative Orthopedic and Sports Medicine
Fellowship-trained & Board Certified in Sports medicine
Director Angiography at Harvard Clinical Research Institute
Michigan State University Alumni


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