Everyone knows that numb, tingly feeling that happens when your foot falls asleep. But if you find yourself regularly losing sensation in your toes, something else might be going on.
"Occasional toe numbness can happen if you're sitting with folded legs for prolonged periods of time," says Kishor Gangani, MD, MPH, an internal medicine physician with Texas Health Arlington Memorial Hospital and Texas Health Physicians Group.
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Same goes for wearing shoes that are too tight: When your feet are squeezed for long stretches, blood flow to the feet or toes can become blocked and cause a pins-and-needles feeling.
If you're noticing the numbness at other times, though, it could be a sign of a medical condition. Here's a look at the most likely causes behind numb toes and what you can do about them.
1. Peripheral Neuropathy
Peripheral neuropathy, where nerves located outside of the brain and spine become damaged, is the most likely cause of frequent toe or foot numbness, Dr. Gangani says. The nerve damage often happens from:
- Undermanaged diabetes
- Autoimmune diseases like rheumatoid arthritis or lupus
- Underactive thyroid
- Kidney or liver disease
- Excessive alcohol use
- Vitamin B12 deficiency
- Infection or injury
- Chemotherapy medications
Neuropathy can cause numbness or weakness in the toes, but it can also be painful, per the Mayo Clinic. You might experience a stabbing or burning sensation in your toes or feet or have pain from everyday activities like putting on socks or putting a blanket over your feet. Symptoms often start off mild and tend to get worse over time.
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Neuropathy can be managed with pain-relieving medications, anti-seizure medications, anti-depressants and exercises that help strengthen your feet. Ointments and pain-relief creams like lidocaine can also ease discomfort, the Mayo Clinic notes.
Working with your doctor to manage the underlying health problem that led to the neuropathy can help keep the numbness or pain from getting worse.
2. Frostbite
If your toe numbness started after spending time in frigid weather, you could have frostbite — where skin freezes in response to very cold temperatures.
The sensation may be accompanied by stinging or swelling and skin that appears very red, blue, purple, or even black.
The Cleveland Clinic notes that anyone can get frostbite, but children and older adults are more likely to be affected.
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Mild frostbite (where your toes feel slightly painful) can be treated at home. Remove any shoes and socks and soak the affected area in warm (not hot) water for 30 minutes. Afterward, drape a blanket over the area to keep it warm, the Cleveland Clinic recommends.
Seek medical attention if your toes are tingly or numb or if you're unable to move them. These are signs of serious frostbite that require emergency care.
3. Nerve Compression Problem
Pinched or compressed nerves can cause a pins-and-needles feeling in your toes that doesn't ease up. You might also have trouble moving your toes or feel a constant dull or sharp ache, according to the Cleveland Clinic.
Women and people with bone spurs, rheumatoid arthritis or thyroid disease are more likely to be affected.
Nerve compression problems can strike in many parts of the body. When the numbness is in your toes, Dr. Gangani says it could be from a condition like:
- Morton's neuroma, where the tissue around the ball of the foot becomes thicker and affects the toe nerve
- Metatarsalgia, or inflammation affecting the ball of the foot
- Tarsal tunnel syndrome, or a compressed nerve in the ankle
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See your doctor if you think you're experiencing nerve compression around your toes. Treatment will vary depending on the specific cause.
In some cases, things like more comfortable shoes, orthotics or steroid injections can give you relief, says the American Academy of Orthopaedic Surgeons (AAOS).
More serious cases might require surgery to correct the problem.
4. Peripheral Artery Disease
Sometimes called PAD, peripheral artery disease can happen when vessels that carry blood from the heart to the legs become narrowed or blocked, usually from fatty buildup. It usually causes pain, aches or cramps in the feet, calves, hips or thighs that gets worse with activity and eases up with rest, per the Centers for Disease Control and Prevention (CDC).
But according to Dr. Gangani, some people can also experience toe numbness.
PAD can affect anyone, but people who have high blood pressure, diabetes or high cholesterol are at higher risk, as are people who smoke, especially if they're over 60.
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PAD can increase your risk for heart attack or stroke, so it's important to see your doctor about your symptoms.
You may be able to manage the condition with heart-healthy habits like diet, exercise, losing weight and quitting smoking, says the National Heart, Lung, and Blood Institute (NHLBI).
In some cases, your doctor might also prescribe antiplatelet medications or statins to help prevent blood clots.
5. Multiple Sclerosis
Less often, numb or tingling toes (especially in just one foot) could be a sign of multiple sclerosis, Dr. Gangani says. The brain and spinal cord disease happens when the immune system mistakenly attacks the protective coating of nerve fibers.
MS symptoms can come and go. In addition to numbness or tingling, it can cause balance problems, vision problems like blurriness or double vision, dizziness, fatigue, slurred speech and mood or cognitive problems, the Mayo Clinic notes.
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There's no cure for MS, but injectable or oral disease-modifying drugs can slow or stop the progression of the disease. Treatments like muscle relaxants, fatigue-reducing medications, physical therapy and antidepressants can help manage symptoms too, per the Mayo Clinic.
When to See a Doctor About Numb Toes
Let your doctor know if you're experiencing frequent toe numbness or if the numbness is happening alongside other concerning symptoms like pain, vision problems or trouble walking or balancing.
Having pins and needles every once in a while isn't a big deal, but numbness that hits often or won't go away could be a sign of an underlying problem, Dr. Gangani says.
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Is this an emergency? If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911.