Foot numbness can make walking uncomfortable or leave you feeling as if your foot has fallen asleep. Sometimes it comes from temporary pressure on a nerve. In other cases, numbness may be related to a condition affecting blood flow, such as peripheral artery disease (PAD).
The challenge is that circulation problems and nerve disorders can cause overlapping symptoms. Paying attention to when numbness occurs, where it happens, and what other changes accompany it can help your healthcare provider determine the cause.
Yes. Reduced blood flow can affect the feet and legs, including causing numbness or a pins-and-needles sensation.
PAD develops when arteries supplying the legs become narrowed or blocked, often because of atherosclerosis, or plaque buildup inside the arteries. When blood flow is restricted, the tissues in the legs and feet may not receive enough oxygen-rich blood.
According to the National Heart, Lung, and Blood Institute, PAD can cause leg or foot weakness and numbness, pain or pins-and-needles sensations, changes in skin color, and a foot that feels colder than the other. Sores on the feet or toes may also heal slowly or fail to heal.
Numbness related to circulation problems may occur along with other changes rather than appearing by itself. For example, you might notice that one foot feels colder than the other, your toes look unusually pale or blue, or your legs become painful or weak when you walk.
That pattern is different from the temporary numbness many people experience after sitting on a foot or sleeping in an awkward position.
Numbness deserves closer attention when it is persistent, repeatedly returns, or occurs alongside symptoms such as:
Having one of these symptoms does not automatically mean you have PAD. A healthcare provider will need to consider your medical history, risk factors, and other possible causes.
Circulation is only one possible explanation for numb feet. Nerve problems are another common cause, particularly when numbness develops gradually or affects both feet.
Peripheral neuropathy occurs when nerves outside the brain and spinal cord become damaged or irritated. Diabetes is a common cause, but nerve problems can also result from certain injuries, vitamin deficiencies, medications, kidney disease, or other medical conditions.
Mayo Clinic notes that peripheral neuropathy often begins in the feet because the nerves reaching the toes are among the body’s longest nerves. Symptoms can include numbness, tingling, burning, sensitivity to touch, and sharp or electrical sensations.
The pattern of symptoms can provide useful information. Nerve-related numbness may affect both feet in a similar pattern and can be accompanied by burning or tingling. A pinched nerve in the back can also cause numbness or pain that travels down one leg.
Circulation-related symptoms may be more closely connected to physical activity or other changes in the affected foot. PAD commonly causes pain, aching, heaviness, or cramping during walking that improves with rest, although not everyone with PAD experiences that classic pattern.
Because the symptoms can overlap, it is better to have persistent numbness evaluated than to assume the cause.
Your healthcare provider will typically start by asking when the numbness began, how often it occurs, and whether anything makes it better or worse. They may also ask about walking, exercise, back problems, diabetes, smoking, medications, and other health conditions.
A physical examination can provide additional clues. Your provider may check:
If PAD is suspected, an ankle-brachial index, or ABI, may be used to compare blood pressure in the ankle with blood pressure in the arm. Additional vascular testing may be recommended if more information is needed.
If the symptoms suggest a nerve disorder, your provider may pursue a different evaluation based on your symptoms and medical history.
The goal is not simply to determine whether numbness is caused by circulation. It is to identify the underlying problem so it can be addressed appropriately.
Occasional numbness that quickly disappears after changing position is usually less concerning. Numbness that keeps returning, lasts for an extended period, or gradually becomes more noticeable should be discussed with a healthcare provider.
Make an appointment if numbness is accompanied by foot or leg pain, weakness, unusual skin color, temperature changes, difficulty walking, or wounds that are slow to heal.
Sudden numbness requires more urgent attention when it occurs with severe pain or a foot that suddenly becomes cold, pale, or blue. A sudden loss of blood flow to a limb is a medical emergency and requires immediate medical evaluation.
Treatment depends on the cause. If PAD is responsible, care may focus on improving blood flow and addressing cardiovascular risk factors such as smoking, high blood pressure, high cholesterol, and diabetes. If a nerve disorder is responsible, treatment will instead focus on the condition affecting the nerves.
The important first step is determining what is actually causing the numbness.
At Colorado Springs Cardiology, discussing changes in sensation, pain, temperature, or skin color with your healthcare provider can help determine whether your symptoms warrant cardiovascular or vascular evaluation.