Why Do My Feet Go Numb? Common Causes and When to Worry

You're sitting on the couch and notice your foot has gone completely numb. Or maybe you wake up at night with tingling that creeps from your toes up toward your ankle. It passes, so you don't think much of it — until it starts happening regularly.

Foot numbness is one of those symptoms that's easy to dismiss but shouldn't be ignored. It can range from a minor positional issue (you sat on your foot wrong) to an early sign of something that needs medical attention. The key is understanding the difference.

The Most Common Causes

Peripheral Neuropathy

This is the leading cause of chronic foot numbness, particularly in adults over 40. Peripheral neuropathy means the small nerves in your feet are damaged and aren't transmitting signals properly. The most common cause is diabetes — even prediabetes can trigger early nerve damage before a patient has been formally diagnosed.

Diabetic neuropathy typically starts in the toes and gradually works its way up. It often presents as numbness, tingling, burning, or a "pins and needles" sensation. The danger isn't just the discomfort — when you can't feel your feet properly, you can't detect cuts, blisters, or pressure sores that can lead to serious infections.

Nerve Compression

A nerve getting pinched or squeezed along its path can cause numbness in the area it supplies. In the foot, the most common culprits are tarsal tunnel syndrome (similar to carpal tunnel but in the ankle) and Morton's neuroma (a thickened nerve between the third and fourth toes that causes numbness and burning in the ball of the foot).

Tight shoes, repetitive stress, and biomechanical imbalances can all contribute to nerve compression. The numbness is often intermittent at first and becomes more persistent over time.

Circulation Issues

Poor blood flow to the feet — peripheral artery disease (PAD) — can cause numbness, coldness, and color changes. This is more common in smokers, diabetics, and patients with high blood pressure or high cholesterol. If your feet are consistently cold and pale or blue-tinged alongside the numbness, circulation should be evaluated.

Positional Compression

The most benign cause: you crossed your legs too long, slept in an awkward position, or wore shoes that compressed a nerve. The numbness resolves within minutes once the pressure is relieved. If this is the only scenario in which your feet go numb, it's usually nothing to worry about.

Other Causes

Less common but worth mentioning: vitamin B12 deficiency, thyroid disorders, alcohol-related nerve damage, spinal stenosis or disc problems that compress nerves before they reach the feet, and certain medications (some chemotherapy drugs are known to cause peripheral neuropathy).

When to See a Podiatrist

A single episode of numbness from sitting on your foot is not a concern. But you should get evaluated if any of the following apply:

• Numbness or tingling that recurs frequently or is getting worse over time
• Numbness that doesn't resolve within a few minutes of changing position
• Both feet are affected (suggests a systemic cause like neuropathy)
• You have diabetes or prediabetes
• Numbness is accompanied by burning, weakness, or difficulty balancing
• You've noticed wounds on your feet that you didn't feel happen

What We Can Do

Evaluation starts with a neurological exam of the feet — testing sensation, reflexes, and nerve conduction. Depending on what we find, treatment may include managing the underlying cause (blood sugar control for diabetic neuropathy), footwear modifications, custom orthotics to redistribute pressure away from compressed nerves, or advanced therapies.

For neuropathy specifically, laser and H-Wave therapy can reduce pain and improve nerve function without medication. For Morton's neuroma, orthotics and padding modifications resolve most cases without surgery.

The Bottom Line

Foot numbness is common but it's not normal. It's your nervous system telling you something has changed — whether that's a nerve being compressed by a tight shoe or early diabetic neuropathy that needs management. The sooner you identify the cause, the more effectively it can be treated. Give us a call at (760) 728-4800 to get it checked out.