Most people have experienced numbness in hands or arms from everyday occurrences like sleeping on your arm or holding a certain position too long. But, what about numbness in toes? Numb toes aren't as common, and can be worrisome. Causes include circulatory, systemic disease, environmental, and inflammatory, so it's important to contact your doctor. Read below to learn more about what causes toe numbness, possible treatments, and more.
7 most common cause(s)
Numbness and tingling in toes explained
Loss of sensation in a body part is often referred to as numbness. Many people have experienced this sensation upon falling asleep for too long on a crooked arm or typing for too long on a keyboard. However, symptoms of toe numbness are not as common an occurrence and can be worrisome. Furthermore, the toe numbness may be associated with other symptoms that may feel strange.
Common accompanying symptoms of toe numbness
If you're experiencing toe numbness, it's likely that you will also experience:
- Burning or tingling
- Pins and needles sensation
- Lack of coordination or falling
- Coldness or sensitivity to touch
- Weak pulse in the legs or feet
- Sores on the toes and feet that take long to heal
These toe numbness symptoms are often temporary, but unlike being able to find quick relief for symptoms such as hand numbness, toe numbness may be more difficult to resolve. As a result, it is important to follow-up with your doctor and get appropriate care as soon as you notice toe numbness symptoms.
What causes numbness in toes?
Toe numbness is the result of injury, compression or irritation of a nerve or a branch of one of the nerves in your foot and sometimes as high up as your leg. The foot is composed of many different nerves and small blood vessels that begin higher up in the leg and branch off in various directions to give blood flow and sensation throughout the foot. Because of this, causes that result in toe numbness are varied, but can be divided into the following categories.
Circulatory causes
Conditions that cause narrowing of the blood vessels can reduce blood flow to the limbs and cause losses in sensation. The toes are especially susceptible because they are farthest from large vessels and may lose circulation first. Narrowing of the blood vessels is most often caused by plaque build-up in the vessels. This process is known as atherosclerosis and is the primary cause of heart disease and stroke.
Systemic disease
Causes related to systemic disease may include the following.
- Metabolic: Dysfunction in the processes that your body uses day-to-day, for example, diabetes, can also affect both the way your nerves function and the diameter of your blood vessels. This causes numbness in the peripheral parts of the body, especially the toes and hands (this condition is known as peripheral neuropathy).
- Hereditary: Some uncommon inherited disorders such as Charcot-Marie-Tooth disease can affect multiple nerves in the body and result in numbness in multiple parts of the body.
Environmental causes
Environmental causes of toe pain may be related to lifestyle habits or certain exposures.
- Toxins: Toxins that cause injury to the nerves include heavy metals such as lead and substances such as alcohol. Too much exposure to either can cause nerve damage that leads to numbness.
- Vitamin imbalance: There are certain vitamins that are essential to healthy nerve function such as vitamins E and B12. Deficiencies in these vitamins over time can lead to nerve damage and injury. Conversely, exposure to too much vitamin B6 can cause numbness or tingling in the toe; however, this would likely require a large amount over a prolonged period.
- Trauma: Any situation where the foot or leg is crushed or damaged will result in toe numbness and nerve pain. However, trauma does not always need to be severe. Circumstances as simple as shoes that are too tight can also cause compressive trauma to the nerves of the feet and toes.
Inflammatory causes
Inflammatory causes of toe pain may be related to the following.
- Autoimmune: Many inflammatory diseases that result in the body attacking itself can also affect the nerves and cause injury that results in numbness. Conditions such as multiple sclerosis and lupus are examples of such autoimmune diseases.
- Infections: Bacterial infections such as Lyme disease and multiple viral infections such as shingles can cause inflammation and nerve injury that results in toe numbness symptoms.
9 possible toe numbness conditions
The list below shows results from the use of our quiz by Buoy users who experienced toe numbness. This list does not constitute medical advice and may not accurately represent what you have.
Tarsal tunnel syndrome
The tarsal tunnel is a narrow space that lies on the inside of the ankle next to the ankle bones. Tarsal tunnel syndrome is a compression, or squeezing, on an important nerve called the posterior tibial nerve. This compression produces symptoms anywhere along the path of the nerve running from the inside of the ankle into the foot.
You should visit your primary care physician who will coordinate your care with a muscle and bone specialist (orthopedic surgeon). Tarsal tunnel syndrome is treated with pain medication, corticosteroid injections, stretching, icing, physical therapy, and also special orthotic inserts for shoes.
Sciatica
Sciatica is a general term describing any shooting leg pain that begins at the spine and travels down the outside of the leg. It is also called pinched nerve, lumbar radiculopathy, sciatic neuralgia, sciatic neuritis, or sciatic neuropathy.
By far the most common cause is a herniated or "slipped" disc in the lower spine. This means some of the cushioning material inside the disc has been forced outward and is pressing on a nerve root. Spasms of the piriformis muscle around the sciatic nerve, as well as the narrowing of the spinal canal called spinal stenosis, can also cause sciatica.
Symptoms include shooting leg pain that begins suddenly or develops gradually. There may be weakness, numbness, and a pins-and-needles sensation. In severe cases, there may be difficulty moving the foot or bending the knee.
Diagnosis is made through patient history, physical examination, and simple leg-raise tests.
Treatment involves physical therapy, nonsteroidal anti-inflammatory drugs, and muscle relaxants. In some cases, corticosteroid spinal injections and surgery may be tried. Massage and acupuncture are also sometimes helpful.
Pes cavus
Pes cavus is a high arch of the foot that does not flatten with weight bearing. This foot type can cause pain.
You should visit your primary care physician if you are experiencing a lot of foot pain. Surgical treatment is only used when there is severe pain.
Morton neuroma
Morton neuroma, also called by the older name Morton's neuroma, is a thickening of fibrous tissue in the ball of the foot. This tissue encapsulates the nerve leading to the third and fourth toes.
It is not actually a tumor of the nerve, as the name suggests. The thickening is caused by years of trauma, irritation, and/or compression to the feet. High-heeled shoes, especially if narrow or tight, are a common cause. The condition is most often seen in women over age 45.
Symptoms include burning pain in the ball of the foot, especially with walking or running. The condition will not heal on its own and can lead to chronic foot pain.
Diagnosis is made through physical examination of the foot with simple range of motion exercises, and sometimes x-ray.
Treatment includes changing to better-fitting shoes that do not compress the nerve; using orthotics in the shoes to take more pressure off of the nerve; and in some cases the use of corticosteroid injections.
Rarity: Rare
Top Symptoms: foot numbness, pain in the sole of the foot, pain when touching the foot, pain in both feet, foot injury
Urgency: Self-treatment
Lower leg weakness
Any leg weakness is a sign of nerve damage, which is very worrisome and requires you to go see a doctor immediately!
Rarity: Uncommon
Top Symptoms: lower leg weakness, foot weakness, arm weakness, loss of vision, severe pelvis pain
Urgency: Hospital emergency room
Low calcium level
Hypocalcemia is a condition where there is not enough calcium in the blood. Calcium is a mineral contained in the blood and helps the heart and other muscles function properly. It is also needed to maintain healthy teeth and bones. Low calcium levels can cause bones to become brittle and more easily fractured. Parathyroid issues and vitamin D deficiency are common causes of this condition.
You should consider visiting a medical professional to discuss your symptoms. Low calcium levels can be evaluated with a review of your symptoms and a blood test. Once diagnosed, treatment depends on the cause of your low calcium levels.
Rarity: Rare
Top Symptoms: fatigue, shortness of breath, irritability, general numbness, tingling foot
Urgency: Primary care doctor
Foot weakness
Any foot weakness is a sign of nerve damage, which is very worrisome and requires you to go see a doctor immediately!
Rarity: Uncommon
Top Symptoms: foot weakness, lower leg weakness, severe pelvis pain, hearing voices or seeing things that aren't there, arm weakness
Urgency: Hospital emergency room
Folate (vitamin) deficiency
Folic acid (folate) is a vitamin that is needed to make new cells in the body, including red blood cells which carry oxygen through the blood and into various tissues throughout the body. Folate deficiency refers to a condition when there is not enough folic acid in the body, and can lead to symptoms such as tiredness, low energy, faintness, and difficulty breathing.
You can safely treat this condition on your own by taking a tablet of folic acid (folate) each day. Folic acid is also naturally occurring in foods such as spinach, sprouts, broccoli, green beans, peas, chickpeas, brown rice, kidney, liver, and potatoes. Eating more of these foods can help with symptoms as well.
Rarity: Rare
Top Symptoms: fatigue, depressed mood, irritability, nausea or vomiting, diarrhea
Symptoms that never occur with folate (vitamin) deficiency: abdominal swelling
Urgency: Phone call or in-person visit
Chronic idiopathic peripheral neuropathy
Peripheral neuropathy refers to the feeling of numbness, tingling, and pins-and-needles sensation in the feet. Idiopathic means the cause is not known, and chronic means the condition is ongoing without getting better or worse.
The condition is most often found in people over age 60. Idiopathic neuropathy has no known cause.
Symptoms include uncomfortable numbness and tingling in the feet; difficulty standing or walking due to pain and lack of normal sensitivity; and weakness and cramping in the muscles of the feet and ankles.
Peripheral neuropathy can greatly interfere with quality of life, so a medical provider should be seen in order to treat the symptoms and reduce the discomfort.
Diagnosis is made through physical examination; blood tests to rule out other conditions; and neurologic and muscle studies such as electromyography.
Treatment involves over-the-counter pain relievers; prescription pain relievers to manage more severe pain; physical therapy and safety measures to compensate for loss of sensation in the feet; and therapeutic footwear to help with balance and walking.
Rarity: Rare
Top Symptoms: distal numbness, muscle aches, joint stiffness, numbness on both sides of body, loss of muscle mass
Urgency: Primary care doctor
Treatment and relief for numb toes
When to see a doctor
If you experience frequent, persistent episodes of toe numbness, visit your doctor to find the exact cause of your condition in order to get appropriate treatment.
At-home treatment
Depending on the cause, your doctor may first suggest other lifestyle modifications such as:
- Balanced diet rich in essential vitamins to keep the nerves healthy: Fruits and vegetables, whole grains, lean proteins, and healthy fats can provide your body with the nutrition necessary to maintain your nerves.
- Regular exercise: Maintaining an optimal weight with exercise and a balanced diet can not only prevent, but also control metabolic diseases such as obesity and diabetes.
- Medications to relax blood vessels: There are many different kinds of medication that can combat constriction in your blood vessels by dilating (relaxing) them and promoting circulation.
- Anticonvulsants: Some anticonvulsant medications can also be used to combat nerve pain such as gabapentin (Neurontin).
- Physical therapy: If your toe numbness is due to trauma that causes compression of the nerves and blood vessels leading to your toes, your doctor may suggest therapy to help take the pressure of these body parts, which also may improve your range of motion and posture.
- Surgery: If other treatments are ineffective and your toe numbness symptoms continue to progress or worsen, your doctor may recommend looking into surgical options to combat your symptoms.
When it is an emergency
If you experience any symptoms of speech difficulty, facial drooping, or weakness to the point you cannot raise your foot or leg, call 911 immediately. These could be signs of a stroke.
Here are some over-the-counter (OTC) treatment options that may help alleviate your symptoms:
- Vitamin B12 Supplements: A deficiency in Vitamin B12 can contribute to nerve damage, potentially leading to numbness. Consider a supplement to support nerve health.
- Magnesium Supplements: Magnesium plays a crucial role in nerve function and a deficiency might cause numbness.
- Comfortable Footwear: Tight or uncomfortable shoes can contribute to toe numbness by putting pressure on nerves.
Questions your doctor may ask about toe numbness
- Have you ever been diagnosed with a psychiatric issue, such as depression, bipolar, schizophrenia, or anxiety disorder?
- While lying down on a firm surface, keep both legs straight. Have a friend slowly raise one leg at a time by lifting your ankle into the air. Do you have pain in that leg before fully raising it to a perpendicular position? (This is called the straight leg test.)
- What is your body mass?
- The foot numbness affects one foot or both feet?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.
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References
- Shelat AM. Numbness and tingling. U.S. National Library of Medicine: MedlinePlus. Updated December 6, 2018. MedlinePlus Link
- Lusis AJ. Atherosclerosis. Nature. 2000;407(6801):233-241. NCBI Link
- Peripheral neuropathy fact sheet. National Institute of Neurological Disorders and Stroke. Updated August 16, 2018. NINDS Link
- Chracot-marie-tooth disease. National Organization for Rare Disorders. Published 2009. NORD Link
- Ask the doctor: Can vitamin B6 cause tingling? Harvard Medical School: Harvard Health Publishing. Published March 2012. Harvard Health Publishing Link
- Numbness or tingling. National Multiple Sclerosis Society. National MS Society Link
- How lupus affects the nervous system. Lupus Foundation of America. Updated July 15, 2013. Lupus Link