SymptomBrain & nerves
Numbness in the Foot
Numbness in the foot is reduced or lost feeling in part or all of the foot, often with tingling, burning or a "dead" or "wooden" feeling. When it affects one foot, the cause is usually a single nerve being pressed: in the lower back (sciatica), at the side of the knee, or at the ankle. Numbness in both feet more often means peripheral neuropathy, commonly from diabetes. Sudden numbness with weakness, or with numbness in the face or arm, needs emergency care.
Also called: Foot numbness, loss of feeling in the foot, foot paresthesia, numb foot
At a glance
- What it is
- Reduced or absent feeling in the foot, often with tingling or burning.
- One foot
- Usually a pinched nerve root in the lower back, peroneal nerve compression at the knee, or tarsal tunnel syndrome.
- Both feet
- Usually peripheral neuropathy from diabetes, alcohol, B12 deficiency or medicines.
- Red flags
- Sudden onset, weakness, foot drop, a cold pale foot, or bladder and bowel changes.
- Tests
- Nerve examination, blood tests, nerve conduction studies and sometimes MRI.
When to get help
Call 911 or go to the ER
- Sudden numbness of the foot with numbness or weakness of the face, arm or leg on the same side, or trouble speaking (possible stroke)
- Numbness in the groin or inner thighs, or new bladder or bowel problems with back pain
- A numb foot that is cold, pale or blue and painful (possible blocked artery)
- Numbness after a leg injury or cast with severe pain and tight swelling (possible compartment syndrome)
See a doctor within a day or two
- Numbness with new weakness, such as a foot that slaps or drags (foot drop)
- Numbness spreading up both legs over hours to days (possible Guillain-Barré syndrome)
- A wound, blister or color change on a numb foot, especially with diabetes
Book a routine appointment
- Numbness or tingling lasting more than a few days, or that keeps coming back
- Numbness in both feet that is slowly spreading upward
- Numbness with back pain and leg pain lasting more than a few weeks
Usually safe to manage at home
- Brief numbness after sitting cross-legged, tight shoes or crossing your legs that goes away within minutes
What foot numbness feels like
People describe it as:
- a "dead", "wooden" or "cotton wool" feeling
- pins and needles or buzzing
- burning, especially at night
- not feeling the floor properly, or feeling as if wearing a sock
- trouble feeling hot water or sharp objects
Loss of sensation matters because injuries go unnoticed, especially in diabetes, and because balance depends on feeling in the feet.
Numbness in one foot vs both feet
| One foot | Both feet | |
|---|---|---|
| Typical causes | Pinched nerve root in the back, nerve compression at the knee or ankle, injury, poor circulation in one leg, stroke | Peripheral neuropathy (diabetes, alcohol, B12 deficiency, medicines, kidney disease) |
| Pattern | Matches the area of one nerve | "Stocking" pattern starting at the toes |
| Onset | Often fairly sudden | Usually gradual over months |
For gradual numbness in both feet, see numbness in feet.
Causes by location in the foot
| Where it is numb | Most likely nerve | Common causes |
|---|---|---|
| Top of the foot and big toe | L5 nerve root or common peroneal nerve | Herniated disc; leg crossing, weight loss, tight casts or knee surgery pressing the nerve at the knee |
| Outer edge and sole, little toe | S1 nerve root or sural nerve | Herniated disc; ankle injury or surgery |
| Sole and toes, burning | Tibial nerve | Tarsal tunnel syndrome at the inside of the ankle |
| Between two toes, usually third and fourth | Small digital nerve | Morton's neuroma, with pain on walking in tight shoes |
| All toes and the sole, both feet | Many small nerves | Peripheral neuropathy |
| The whole foot, cold and pale | Blood supply | Peripheral artery disease or an acute blocked artery |
Common causes
Pinched nerve in the back (sciatica)
A herniated disc or spinal stenosis can compress the L5 or S1 nerve root. Numbness on the top or outer side of the foot usually comes with lower back pain and pain running down the back or side of the leg. See sciatica.
Peroneal nerve compression
The common peroneal nerve wraps around the bony outer side of the knee just under the skin. Habitual leg crossing, squatting, prolonged bed rest, a tight cast or brace, rapid weight loss or a knee injury can compress it. It causes numbness on the top of the foot and, if severe, foot drop.
Tarsal tunnel syndrome
Compression of the tibial nerve on the inside of the ankle causes burning, tingling and numbness in the sole, worse with standing and walking. See tarsal tunnel syndrome.
Peripheral neuropathy
Damage to many nerves usually starts in both feet:
- Diabetic neuropathy: the most common cause in the US
- Alcohol overuse
- Vitamin B12 deficiency, including from long-term metformin or acid-reducing medicines, or a vegan diet without supplements
- Chemotherapy and some other medicines
- Kidney failure, underactive thyroid and HIV
- Inherited neuropathies such as Charcot-Marie-Tooth disease
Circulation problems
Peripheral artery disease reduces blood flow to the leg, causing calf pain on walking and, when advanced, a cold, numb foot. A sudden cold, white, painful, numb foot is an emergency.
Other causes
- Tight shoes, high heels and lacing too tightly
- Frostbite and cold exposure
- Multiple sclerosis, with numbness that may come and go
- Stroke, usually with arm and face symptoms
- Injury, including ankle sprains and fractures
How the cause is found
The doctor will ask when it started, exactly where it is, whether it affects one or both feet and about back pain, diabetes, alcohol, medicines and diet. They will test sensation, strength (standing on heels and toes), reflexes and the pulses in the feet. Tests may include:
- blood sugar and HbA1c, vitamin B12, thyroid and kidney function
- nerve conduction studies and electromyography (EMG)
- MRI of the lower back if a nerve root is suspected
- ankle-brachial index or Doppler ultrasound for circulation
Treatment
- Sciatica: activity, physical therapy and pain relief; injections or surgery if severe or persistent.
- Peroneal nerve compression: stop leg crossing, adjust casts or braces; most recover over weeks to months. An ankle brace helps foot drop.
- Tarsal tunnel syndrome: supportive shoes, orthotics, rest and sometimes injection or surgery.
- Neuropathy: control blood sugar, stop alcohol, replace B12, review medicines. Prescription medicines can ease burning nerve pain.
- Circulation problems: stop smoking, supervised walking, medicines and sometimes procedures to restore blood flow.
Protect a numb foot
- Check your feet every day for cuts, blisters and color changes; use a mirror for the soles.
- Test bath water with your elbow or a thermometer.
- Wear well-fitting shoes and never walk barefoot.
- See a podiatrist regularly if you have diabetes.
Frequently asked questions
What causes numbness in one foot?
The most common causes are a pinched nerve in the lower back (sciatica), compression of the peroneal nerve at the knee, tarsal tunnel syndrome at the ankle, and Morton's neuroma between the toes. Less often, poor circulation or a stroke is responsible, especially if numbness is sudden.
Why is the top of my foot numb?
Numbness on the top of the foot usually means the L5 nerve root in the lower back or the peroneal nerve at the outer knee is compressed. Leg crossing, tight boots, recent weight loss and a herniated disc are common triggers. Weakness lifting the foot needs prompt assessment.
Is foot numbness serious?
It depends on the cause. Brief numbness from sitting awkwardly is harmless. Persistent numbness should be checked, because diabetes, B12 deficiency and nerve compression are treatable. Sudden numbness with weakness, face or arm symptoms, a cold foot or bladder problems is an emergency.
Can diabetes cause numbness in one foot?
Diabetic neuropathy usually affects both feet, starting in the toes. Diabetes can also cause single-nerve problems (mononeuropathy), so one foot may be affected. Anyone with diabetes and new foot numbness should check their feet daily and see their doctor.
Sources
This guide was written from current patient and clinical guidance, including:
- National Institute of Neurological Disorders and Stroke (NINDS): Peripheral neuropathy
- MedlinePlus (US National Library of Medicine): Numbness and tingling
- American Diabetes Association: Neuropathy and foot care
- American Academy of Orthopaedic Surgeons (AAOS) OrthoInfo: Tarsal tunnel syndrome
- NHS: Numbness and tingling