What does it mean to have tingling feet?

Timothy Maly, MD, is a family practitioner at Berthoud Family Physicians in Berthoud, Colo.

Question: My feet tingle. Could it be peripheral neuropathy?

Answer: Some people blame tingling or numbness in the feet on tight shoes. If it’s a condition that bothers you regularly, you should have it evaluated to avoid more serious problems.

The condition could be peripheral neuropathy – diseased nerves in your feet. The tingling or numbness in your foot makes it unable for you to sense pain. As a result, you are more likely to suffer an injury to your foot without knowing it.

If the nerves in your feet are diseased, they are unable to send signals properly to your brain. In that case, you will lack feeling in your feet or may have that tingling. The symptom typically begins in your toes and spreads up your feet as more of the nerves are affected.
As more of the nerves are affected, the chances of you not sensing an injury increase. That might mean a cut or even a broken bone is ignored. The risk there is cuts that go unnoticed can become infected. Bone fractures left untreated can heal improperly and result in a deformity.

Common causes for peripheral neuropathy include diabetes, shingles, vitamin deficiency – particularly B12 and folate, alcohol, autoimmune diseases including lupus, rheumatoid arthritis and Guillain-Barre syndrome, AIDS, syphilis and kidney failure, exposure to certain toxins and certain cancer therapy drugs.

Peripheral neuropathy can be treated depending on the cause, so the first step is identifying why the nerves are damaged. Courses of treatment can include correcting vitamin deficiencies or controlling diabetes.

If you do have neuropathy in your feet, it is important that you follow special precautions.

• Check your feet regularly. This sounds comical, but as we age, it does get harder to give our feet the attention they need. You can use a mirror to see the bottom of your feet. Look for changes and check the bottom of your feet, your heels and between your toes. If you aren’t able to do this, ask for help. Call your health care provider if you notice swelling, redness, ingrown nails or other sensitive areas.
• Wear proper shoes and socks, even inside the house. Because the neuropathy will mask an injury, you might not realize it if you step on a sharp object, drop something on your foot or stub your toe. When you buy new shoes, you should check frequently at the beginning to make sure they fit properly and are not causing blisters or irritation. If you have questions about what shoes to buy, ask your health care provider. Finally, before putting on shoes, check to make sure nothing strange or sharp is inside the shoe.
• Practice proper foot care. Take care in properly trimming your toenails. The neuropathy may keep you from feeling it when you cut yourself or trim the nail incorrectly. To avoid problems, you can ask your health care provider to help with trimming nails and calluses. Also, some senior centers and groups offer to assist with this. Before stepping into the bath, check the water temperature with your elbow or hand rather than your foot to avoid burns.