What Causes Numbness and Tingling in the Heels? Possible Conditions Explained

What Causes Numbness in the Heels?

Heel numbness is a common symptom that can have many underlying causes. Experiencing a lack of sensation or "pins and needles" in the heels can be uncomfortable or even painful.

Sometimes the cause is obvious, like wearing shoes that are too tight. But in other cases, persistent heel numbness can signal an underlying neurological, vascular, or musculoskeletal condition that needs medical attention.

By understanding the most common reasons behind numb heels, you can get to the root of the problem and find the right treatment.

Causes of Numb Heels

Here are some of the most frequent explanations for numbness in the heels:

1. Shoe-Related Pressure

Wearing shoes that are too tight or have a narrow toe box can compress the heels and irritate nerves, leading to numbness, tingling, and pain. High heels and ill-fitting boots are common culprits.

The compression limits blood flow, oxygen, and nutrient delivery to the heel tissues. This can damage the nerves over time.

Changing to well-fitted, low-heeled shoes with adequate room in the toe box can help relieve pressure and irritation of the heel nerves.

2. Plantar Fasciitis

Plantar fasciitis is inflammation of the band of tissue (plantar fascia) running across the bottom of the foot from the heel bone to the toes. It can cause heel pain and numbness.

The plantar fascia supports the foot's arch. But overuse and repetitive strain can lead to tiny tears in the fascia. Inflammation and scarring then develop as the body tries to repair the damage.

The swollen, irritated tissue presses on the heel nerves, leading to numbness. Heel spurs may also form and put additional pressure on nerves.

Stretching, rest, massage, orthotics, night splints, physical therapy, and anti-inflammatory medications can help.

3. Tarsal Tunnel Syndrome

The tarsal tunnel is a narrow passageway on the inside of the ankle beside the ankle bone. It protects the tibial nerve that runs down the back of the leg and into the foot.

When the tissues around the tibial nerve become inflamed or damaged, they can press on the nerve. This causes numbness, tingling, and burning pain on the inside of the ankle and heel.

Causes include sprains, arthritis, bone spurs, cysts, and flat feet. Wearing tight shoes or socks can also contribute by aggravating the condition.

Treating the underlying cause can help. Steroid injections, physical therapy, orthotics, and surgery are sometimes needed for cases that don't improve with other measures.

4. Peripheral Neuropathy

Peripheral neuropathy is nerve damage that typically starts in the hands and feet and progresses up the arms and legs. It can be caused by:

• Diabetes
• Vitamin deficiencies
• Autoimmune diseases
• Infections
• Chemotherapy
• Medications
• Trauma or compression injuries
• Genetic disorders
• Alcohol abuse
• Toxins

In many cases, managing the underlying condition can prevent further nerve damage and help nerves heal.

5. Nerve Entrapment

Nerves that run through the lower legs and feet pass under or between muscles and other structures. If swelling, scar tissue, or musculoskeletal imbalances compress these nerves, it can cause numbness and pain.

Common entrapment sites include the tarsal tunnel, the space behind the medial malleolus, and the fibular tunnel beside the fibula bone. Trigger points in muscles can also entrap nerves.

Identifying and addressing sources of compression through massage, stretching, orthotics, and physical therapy techniques can help relieve symptoms.

When to See a Doctor

Occasional mild heel numbness that resolves when you remove your shoes is usually nothing to worry about. But seek medical advice if you experience:

• Persistent or worsening heel numbness
• Burning, tingling, or shooting pain
• Weakness in the feet
• Numbness that extends up the leg
• Loss of foot coordination or balance

These symptoms could indicate an underlying condition that needs treatment. Prompt evaluation and diagnosis are key to halting progression and reversing damage before it becomes irreversible.

Diagnosing the Cause of Numb Heels

To pinpoint why your heels are numb, your doctor will likely:

• Ask about your symptoms and medical history
• Conduct a physical exam of your feet and legs
• Order blood tests to check for diabetes, vitamin deficiencies, etc.
• Refer you for imaging tests like x-rays, MRI, or nerve conduction studies

Based on the findings, they can identify potential causes and recommend appropriate treatment options.

Common Conditions Behind Numb Heels

While there are many possible reasons for numb heels, some of the most common include:

1. Diabetic Neuropathy

Over half of people with diabetes eventually develop nerve damage known as diabetic neuropathy. The nerves in the feet and legs are often affected first.

High blood sugar injures the nerve fibers, causing numbness, tingling, burning, and pain. The feet and heels feel numb or overly sensitive.

Getting blood sugar under tight control can help prevent neuropathy from worsening. Medications, physical therapy, orthotics, and surgery may also be used for symptom management.

2. Sciatica

The sciatic nerve runs from the lower back down the back of each leg. Sciatica refers to irritation of this nerve, often due to a herniated spinal disk pinching the nerve.

Shooting, burning leg and foot pain are classic sciatica symptoms. Numbness and tingling can also occur in the heels when the compressed nerve can't properly signal the heel tissues.

Anti-inflammatory drugs, physical therapy, massage, chiropractic adjustment, and surgery are used to treat the source of nerve compression.

3. Peripheral Artery Disease (PAD)

PAD involves atherosclerosis, or hardening and narrowing of the arteries from fatty deposits. When arteries to the legs and feet are blocked, it can cause numb, painful heels.

Poor circulation deprives nerves and other tissues of oxygen. Medications, angioplasty, or bypass surgery can improve blood flow and relieve PAD symptoms.

4. Vitamin B12 Deficiency

Vitamin B12 supports nerve health. Not getting enough, often due to low stomach acid levels or medications, can damage nerves.

Shortness of breath, fatigue, balance issues, and neuropathy symptoms like numb, tingling heels and feet can occur. Correcting the deficiency with supplements or injections can help.

5. Chemotherapy

Certain chemotherapy drugs are toxic to nerves. They can damage nerve endings in the hands and feet, causing numbness, pain, tingling, and weakness during and after cancer treatment.

Symptoms tend to improve over time once chemotherapy is finished. But some people have persistent neuropathy requiring medication, physical therapy, pain management, and orthotics.

When to Seek Emergency Care

In rare cases, sudden heel numbness can signal a medical emergency requiring immediate care. Go to an emergency room or call 911 if numb heels occur with:

• Sudden, severe back pain
• Loss of bowel or bladder control
• Paralysis or inability to move the legs
• Severe weakness

These symptoms can happen with nerve damage from a herniated disc, spinal injury, stroke, or other neurological emergency.

Prompt diagnosis and treatment are crucial to prevent permanent disability. Don't ignore or try to "wait out" sudden severe numbness.

Relieving Numbness in the Heels

Treatment focuses on identifying and addressing the root cause of heel numbness whenever possible.

But additional strategies to relieve discomfort include:

• Wearing well-cushioned shoes with low heels and a roomy toe box.
• Using heel cushions or pads.
• Doing calf and foot stretches and exercises to improve circulation and range of motion.
• Massaging the heels and calves.
• Trying ice packs or heating pads.
• Taking over-the-counter pain relievers like NSAIDs.
• Resting the feet and avoiding prolonged standing or walking.

Your doctor may also recommend prescription medications, orthotics, physical therapy, or surgery depending on the cause.

When to Call the Doctor About Numb Heels

Schedule an appointment with your doctor if heel numbness:

• Happens frequently or persists, even at rest
• Is accompanied by pain, tingling, burning, or weakness
• Spreads up your foot or leg
• Affects your balance or ability to walk
• Doesn't improve with stretching and orthotics

Ongoing numbness is usually a red flag for an underlying issue needing diagnosis. Catching and treating problems early on can help prevent the symptoms from worsening over time.

Don't write off recurrent heel numbness as normal or ignore it. See your doctor to determine the cause and proper treatment.

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.