What's Behind Numbness in the Heels? A Thorough Guide

Understanding Numbness in the Heels

It can be alarming when one experiences a sudden numbness or tingling sensation in the heels when walking or standing. While this may potentially indicate an underlying condition like multiple sclerosis, there are various possible causes for heel numbness that should be explored.

What Causes Numb Heels?

Heel numbness arises when there is compression, damage or dysfunction affecting the nerves supplying sensation to the heels and feet. Potential causes include:

• Plantar Fasciitis - Inflammation of the plantar fascia tissue running along the bottom of the feet.
• Heel Spurs - Calcium deposits causing bony protrusions on the heel bone.
• Arthritis - Cartilage breakdown in foot joints from osteoarthritis or autoimmune conditions.
• Diabetes - Nerve damage from chronically high blood sugar levels.
• Achilles Tendonitis - Swelling of the Achilles tendon at the back of the heel.
• Flat Feet - Fallen foot arches putting strain on heel tissue.
• Tarsal Tunnel Syndrome - Compression of the tibial nerve as it passes behind the ankle.
• Baxter's Nerve Entrapment - Damage to the nerve running under the heel bone.
• Spinal Issues - Nerve root compression in the lumbar spine region.

Differentiating Multiple Sclerosis

Numb heels or feet can also occur from nerve signaling disruption resulting from central nervous system myelin sheath damage in multiple sclerosis (MS). However, heel numbness from MS differs in several key ways:

• Bilateral Numbness - Usually occurs in both feet rather than one.
• Intermittent Issues - Numbness comes and goes rather than being constant.
• No Pain - Typically little or no pain associated.
• Other Symptoms - Accompanied by broader neurological symptoms like visual changes, fatigue, bladder dysfunction etc.
• Lesion Locations - Caused by demyelinating lesions in the brain and central spinal cord rather than peripheral nerves.

Medical Evaluation of Numb Heels

Getting an accurate diagnosis is crucial when experiencing heel numbness to identify if it stems from MS versus other causes. Input from specialists and testing may be warranted.

Seeking A Neurologist’s Opinion

A neurologist thoroughly evaluates neurological symptoms like numb heels to pinpoint if central versus peripheral nervous system involvement exists. They assess one's case history, risk factors, presentation pattern and explore other potential explanations first.

A neurologist may order imaging like MRI scans to check if visible demyelination in pathways correlating to numb heels is present. Other testing options are:

• Nerve conduction studies analyzing electrical impulses passing through peripheral nerves.
• Somatosensory evoked potential (SSEP) tests evaluating central nervous system pathway integrity.
• Lumbar puncture examining cerebrospinal fluid for inflammation markers.

Podiatry Consultation for Feet

Podiatrists specialize in foot health, providing a clinical inspection of one’s feet and heels to assess areas of discomfort or dysfunction. Custom orthotics may be prescribed to correct biomechanical imbalances contributing to nerve irritation.

Diagnostic techniques to pinpoint causes include:

• X-rays revealing heel spurs, bone deformities or arthritis.
• Ultrasound scanning tendons, ligaments and soft tissue for tears or inflammation.
• Nerve conduction measuring transmission along foot nerves.

Ruling Out Spinal Compression

A spine specialist performs a neurological exam checking for spinal nerve impingement contributing to referred lower body symptoms. Imaging like MRI evaluates for a herniated disc or spinal stenosis compressing nerve roots.

Remedies and Treatment Options for Numb Heels

Treatment approaches for numb heels focus on correcting the underlying diagnosis if established, providing nerve calming strategies plus symptomatic relief. A combined game plan may incorporate:

Medications

Medications that may be prescribed based on one’s specific diagnosis include:

• Steroid injections reducing nerve irritation or tissue inflammation from pathologies like heel spurs, tendonitis or tarsal tunnel syndrome.
• NSAIDs lessening pain or swelling from conditions causing heel numbness.
• Immunotherapies slowing MS disease progression plus managing acute symptom flares.
• Nerve blocks numbing overactive pain signals from damaged nerves.

Rehabilitation Therapy

Physical, occupational or massage therapy provides modalities like:

• Exercises targeting flexibility, strength, balance and gait.
• Orthotics realigning foot posture and shock absorption.
• Soft tissue massage loosening muscles, mobilizing joints.
• Pain relief techniques using electrical stimulation, ultrasound or taping.

Lifestyle Measures

Additionally:

• Resting feet regularly minimizes agitation.
• Good footwear cushions impact for activity.
• Stretching calf muscles aids circulation.
• Elevation and ice alleviates swelling.
• Weight management reduces joint loading.

Consider Advanced Interventions

More invasive options like nerve decompression surgery or epidural spine injections may be warranted depending on one’s circumstances.

When To Seek Emergency Treatment

Despite appropriate treatment, worsening neurological symptoms like spreading lower body numbness or weakness warrants prompt medical reevaluation to exclude dangerous causes like:

• Spinal compression from a ruptured disc or bleed causing severe nerve impingement.
• Nerve damage from disturbingly high blood sugar levels in diabetics.
• Blocked blood vessels cutting circulation to nerves often occurring in the back or inside the skull.
• Guillain-Barre syndrome an autoimmune reaction severely disrupting peripheral nerve signaling.

Rapidly progressive numbness, pain or paralysis demands emergency spinal assessment.

Outlook for Numb Heels

Prognosis for numb heel resolution varies based on the exact cause. Seeking prompt diagnosis and treatment aids recovery. Communicate any evolving, atypical or worrying symptoms to physicians.

While multiple sclerosis lesions contribute to numbness for some, many other explanations for this symptom exist. Thorough professional evaluation explores all possible reasons to pinpoint appropriate management.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.