Understanding And Treating The Causes Of Numbness In The Heels

Understanding Numb Heels: Possible Causes and Treatment Options

Waking up one morning to find that your heels feel numb or tingly can be an unsettling experience. Numbness or tingling in the heels often indicates an underlying medical issue that requires diagnosis and treatment.

While the causes of numb heels can vary, some of the most common include:

Nerve Damage or Compression

One of the most frequent reasons people experience numb heels is nerve damage or compressed nerves in the legs and feet. The nerves running down the leg can become damaged or pinched for various reasons:

• Diabetes is a leading cause of nerve damage (diabetic neuropathy) that leads to numbness in the feet and heels.
• Injuries, such as fractures or dislocations of the leg, knee, or ankle can stretch or compress nerves.
• Lumbar spinal stenosis, or narrowing of the spinal canal in the lower back, can pinch nerves that run down the legs.
• Sciatica caused by a herniated disc or other back issues can compress the sciatic nerve, causing heel and foot numbness.

Treating the underlying condition, such as diabetes, injuries, or spinal disorders, is key to alleviating nerve-related numbness in the heels. Doctors may recommend medications, physiotherapy, braces, surgery, or other interventions depending on the specific cause.

Blood Flow Problems

Reduced blood circulation to the feet can also result in heel numbness. Some reasons for decreased blood flow include:

• Peripheral artery disease causes narrowing of the arteries supplying the legs and feet.
• Diabetes often leads to poor circulation in the extremities.
• Cold temperatures cause blood vessels to constrict.
• Injuries, blood clots, or vascular disorders can restrict blood flow.

Treating any underlying cardiovascular conditions can help improve circulation. Keeping the legs and feet warm, regular exercise, not smoking, losing weight, and certain medications can also aid blood flow.

Chronic Conditions

In addition to diabetes, various chronic health conditions can contribute to numbness in the heels, including:

• Multiple sclerosis - Nerve damage from MS lesions can cause numb heels and feet.
• Fibromyalgia - This condition causes widespread muscle pain and tender points that can extend into the heels.
• Lupus - Inflammation from this autoimmune disease can damage nerves.
• Thyroid disorders - Both overactive and underactive thyroid can cause numbness and tingling.
• Nutritional deficiencies - Lack of vitamins B12, folate, and iron can affect nerve function.

While these chronic diseases may not be curable, managing symptoms through medications, lifestyle changes, physical therapy, and treating any nutritional deficiencies can help alleviate related numbness.

Infections

Infections that affect the nerves, bones, or soft tissues around the heels can sometimes cause temporary numbness, including:

• Shingles outbreaks on the legs/feet.
• Bone infections (osteomyelitis) in the heel or ankle bones.
• Soft tissue infections like cellulitis.
• Nerve infections such as neuritis.

Powerful prescription antibiotics are typically needed to treat any infections causing numb heels. Antiviral medications may also be used for shingles. Any decayed or infected bone may need surgical debridement.

Autoimmune Disorders

Autoimmune diseases, where the immune system attacks the body's own tissues, can sometimes damage nerves and cause numbness. Examples include:

• Guillain-Barre syndrome.
• Chronic inflammatory demyelinating polyneuropathy (CIDP).
• Vasculitis problems like polyarteritis nodosa.

Immunosuppressive drugs may be prescribed to calm the immune system attacks. Plasma exchange, IVIG therapy, physical therapy, and other treatments can also help manage symptoms.

Chemotherapy Drugs

Powerful chemotherapy medications used to treat cancer can sometimes cause peripheral neuropathy as a side effect, damaging nerves in the heels and feet. While neuropathy from chemo may improve over time, controlling symptoms with prescription medications is often necessary during cancer treatment.

Alcohol Abuse

Long-term excessive alcohol consumption can contribute to nerve damage and nutritional deficiencies, both potentially leading to numb heels. Quitting alcohol, eating a balanced diet, and taking nutritional supplements can aid recovery.

When to See a Doctor

In most cases, numbness in the heels is not an emergency, but you should still have it evaluated promptly. See a doctor right away if numb heels are accompanied by:

• Loss of bowel/bladder control.
• Sudden onset of paralysis.
• Severe muscle weakness.
• Unexplained weight loss.

These symptoms can indicate a serious neurological issue requiring immediate treatment, like a tumor, stroke, or spinal injury. Even without other symptoms, schedule an appointment within a few days to identify the cause of heel numbness.

Diagnosing Numb Heels

To diagnose the underlying cause of numb heels, doctors use:

• Medical history - Discuss any chronic conditions, injuries, nutritional issues, alcohol use, or associated symptoms.
• Physical exam - Test reflexes, muscle strength, balance, circulation, and neurological function.
• Blood tests - Check for diabetes, vitamin deficiencies, thyroid problems, and other medical conditions.
• Nerve conduction study - Measures how well nerves transmit signals.
• MRI - Creates images of soft tissues like nerves, spinal cord, and discs.
• CT scan - Provides images of bones, joints, and blood vessels.

Identifying the source of the nerve damage or circulation problems allows appropriate treatment.

Treating Numb Heels

Treatment for numb heels focuses on the underlying cause, which could include:

• Diabetes management - Controlling blood sugar levels can help minimize nerve damage and circulation problems.
• Physical therapy - Stretching, exercises, ultrasound, electrical stimulation, and balancing techniques help reduce numbness.
• Orthotics - Custom shoe inserts support the arches and distribute pressure evenly across the feet.
• Medications - Prescription drugs can treat infections, chronic diseases, nerve pain, and poor circulation.
• Surgery - Procedures may be done to remove spinal disc herniations, repair fractures or injuries, or bypass blocked arteries.

Lifestyle measures like eating nutritious foods, exercising regularly, avoiding toxins like smoking and alcohol, and reducing stress also benefit overall nerve and cardiovascular health.

Home Care and Prevention

While waiting for numb heels to resolve, caring for your feet is important:

• Wear comfortable, protective shoes with cushioned soles.
• Inspect feet daily for cuts, blisters, or skin breakdowns.
• Clean and moisturize feet to prevent cracking and infection.
• Avoid walking barefoot.
• Elevate feet when possible to improve circulation.
• Use warm (not hot) compresses to increase blood flow.
• Take over-the-counter pain relievers if needed.

Making healthy lifestyle choices can also help prevent heel numbness, such as:

• Exercising regularly.
• Eating a balanced diet.
• Reaching/maintaining a healthy weight.
• Quitting smoking.
• Limiting alcohol intake.
• Controlling chronic conditions like diabetes.

When to Seek Emergency Care

Seek emergency medical care if numb heels occur with:

• Sudden paralysis or inability to move the legs
• Loss of bladder or bowel control
• Unexplained fever or confusion
• Bleeding, open sores, or ulcers on the heels

These symptoms can indicate a spinal injury, stroke, or rapidly worsening neurological or circulatory issue needing urgent evaluation and treatment.

Outlook for Numb Heels

The prognosis for numb heels depends on the underlying cause. Nerve-related heel numbness often improves over weeks or months if prompt treatment is received. Numbness from permanent nerve damage may persist but still benefit from various treatments to control symptoms. Proper foot care is vital to prevent wounds or infections.

While frustrating, numb heels are rarely a medical emergency. Getting an accurate diagnosis leads to better outcomes. With appropriate treatment guided by your doctor, numb heels can often be managed effectively.

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.