Tingling in the feet is a common concern. Many people experience a “pins and needles” sensation in their feet at some point. In addition, the feet may often feel numb and painful.

This isn’t usually a reason for concern. Tingling may be caused by pressure on the nerves when you’ve been in one position for too long. The feeling should go away when you move.

However, tingling in the feet may be persistent. If the “pins and needles” feeling continues for a long period of time or is accompanied by pain, see your doctor. They can help you determine the cause.

A variety of chronic conditions can cause tingling in the feet, including:

  • diabetes and diabetic neuropathy
  • multiple sclerosis (MS)
  • hypothyroidism
  • Tarsal tunnel syndrome (TTS)
  • kidney failure
  • Charcot-Marie-Tooth (CMT) disease
  • autoimmune diseases
  • infections
  • alcohol use disorder and alcoholic neuropathy

Diabetes and diabetic neuropathy

Diabetes — and a related complication known as diabetic neuropathy — is one of the most common causes of persistent tingling in the feet. Diabetic neuropathy is the result of nerve damage caused by high blood sugar.

Symptoms of diabetes include:

Diagnosis and treatment

A healthcare professional will take a medical history, complete a physical exam, and run blood tests to determine whether you have diabetes or if your diabetes is causing your tingling feet.

Diabetes can be managed with lifestyle changes and medications, such as insulin.

Multiple sclerosis (MS)

Multiple sclerosis (MS) is a central nervous system disease that causes the immune system to attack the protective covering on nerves, or myelin.

This results in nerve damage and disruption in communication between the brain and body.

Tingling or numbness in the body, face, and extremities (hands and feet) is one of the most common symptoms of MS.

Other symptoms of MS include:

Diagnosis and treatment

Currently, there are no laboratory tests that can determine whether you have MS. Before diagnosing you with MS, a healthcare professional will want to rule out all other possible causes of your tingling feet.

Then they’ll use several strategies to determine if your symptoms meet the criteria for an MS diagnosis, including:

Although there’s no cure for MS, there are many treatment options available to help slow the progression of the disease and manage symptoms.

Hypothyroidism

Hypothyroidism is a condition in which your thyroid is underactive and can’t produce enough thyroid hormone to support your body’s needs.

Symptoms of hypothyroidism may seem mild, or they may be easily attributable to other conditions at first. These symptoms include:

Untreated hypothyroidism can lead to more severe complications, including peripheral neuropathy. Peripheral neuropathy is damage to your peripheral nerves. Tingling and numbness in your feet is one of the effects of peripheral neuropathy.

Diagnosis and treatment

To diagnose hypothyroidism, your doctor will order a blood test called a thyroid-stimulating hormone (TSH) test. High TSH levels may indicate that you have hypothyroidism.

Treatment usually involves taking an oral synthetic thyroid hormone called levothyroxine (Levoxyl, Synthroid, and Unithroid). Your doctor will monitor your TSH levels and adjust your levothyroxine dosage as needed.

Treatment for hypothyroidism is usually lifelong.

Tarsal tunnel syndrome (TTS)

Tarsal tunnel syndrome (TTS) causes pain, tingling, or burning in the ankle, heel, or foot. This condition is caused by compression of the tibial nerve, which runs along the inside of the ankle and foot.

Diagnosis and treatment

To diagnose TTS, a healthcare professional will ask you about your symptoms and medical history. They’ll also run specialized tests.

They’ll likely perform a Tinel’s sign test, during which they’ll put pressure on your tibial nerve. If this pressure results in tingling in your foot, the test is considered positive for TTS.

Treatment for TTS will vary depending on the individual and their symptoms.

If you’re diagnosed with TTS, you may be encouraged to rest, take anti-inflammatory drugs, or wear orthotics to correct the position of your foot. Other treatments include physical therapy or corticosteroid injections to reduce pain or inflammation.

If symptoms are severe or they persist despite treatment, a doctor may recommend surgery to decompress the nerve.

Kidney failure

Kidney failure may cause tingling in the feet. Kidney failure can have many causes, but the most common are diabetes and high blood pressure.

Symptoms of tingling feet caused by kidney failure include:

  • pain and numbness in the legs and feet
  • cramping and muscle twitches
  • muscle weakness

Diagnosis and treatment

Your doctor may perform a number of tests to determine if kidney failure is causing your tingling feet. Tests may include:

Treatment for kidney failure includes dialysis and a kidney transplant.

Charcot-Marie-Tooth (CMT) disease

Charcot-Marie-Tooth (CMT) disease is a group of peripheral nerve disorders that result in:

Tingling, numbness, or a burning sensation in your hands and feet are symptoms of CMT.

Additional symptoms include:

  • weak foot, ankle, and lower leg muscles
  • muscle loss in your feet and legs
  • gait difficulties, which are marked by tripping and falling, having trouble running, and having an awkward step
  • foot deformities, which often include high arches or hammer toes
  • foot drop, or difficulty lifting the front part of the foot

Diagnosis and treatment

In order to diagnose CMT, your doctor may have you see a neurologist. The neurologist will ask for your family medical history and perform a neurological exam.

They may also run tests, including:

  • blood tests to look for genetic abnormalities
  • an EMG
  • a nerve biopsy
  • a nerve conduction study

There’s currently no cure for CMT, but most people with the condition can remain active and have a normal life span.

Treatment can help you manage symptoms. Your doctor or neurologist may suggest:

Autoimmune diseases

Autoimmune diseases occur when the body attacks itself. A number of autoimmune diseases can cause tingling in the feet. Some of these conditions include:

Diagnosis and treatment

To determine if an autoimmune disease is causing the tingling in your feet, your doctor will take a detailed family and medical history, complete a physical exam, and likely run a number of blood tests.

Treatments for autoimmune diseases vary. They may include dietary changes and medications.

Infections

A number of infections can cause inflammation of the nerves, which can lead to tingling in the feet. These infections include:

Diagnosis and treatment

See a healthcare professional if you think you may have an infection. They’ll take a medical history, complete a physical exam, and likely draw blood to test for infectious diseases.

Treatment will vary depending on which infection you have, but it’ll likely include medication.

Alcohol use disorder and alcoholic neuropathy

Drinking heavily on a regular basis can cause alcoholic neuropathy, which is damage to the peripheral nerves due to excessive alcohol consumption. It’s estimated that 46.3 percent of people who chronically misuse alcohol experience peripheral neuropathy.

People who develop alcoholic neuropathy may experience tingling in their feet, hands, or limbs that lasts anywhere from a few months to several years.

Additional symptoms of alcoholic neuropathy include:

Alcohol use disorder is also associated with malnutrition and vitamin deficiencies. Because of this, determining whether tingling in the feet is due to alcoholic neuropathy or neuropathy caused by nutritional deficiencies can be difficult.

Diagnosis and treatment

To diagnose alcoholic neuropathy, a healthcare professional may ask you about your history of alcohol consumption. It’s important to be open about your alcohol use in order to receive a correct diagnosis.

They’ll also run tests, including:

The most important steps in treating alcoholic neuropathy are considering stopping drinking and seeking treatment for alcohol use disorder. You may also be encouraged to take vitamin supplements.

A healthcare professional may prescribe physical therapy or pain medication to manage the tingling and pain in your feet.

However, even if a person quits drinking, their symptoms of alcoholic neuropathy may be permanent.

Short-term conditions can also cause tingling in the feet.

Pregnancy

It’s not uncommon to experience tingling in your feet during pregnancy. As the uterus grows, it can put pressure on the nerves that run down the legs. This causes the “pins and needles” sensation.

Treatment

You may be able to relieve the tingling by:

If the tingling worsens, doesn’t go away, or is accompanied by weakness or swelling, see your doctor to make sure nothing serious is going on.

Vitamin deficiency

Not getting enough of certain vitamins, particularly B vitamins, can cause tingling in the feet. Vitamin deficiency can be the result of an inadequate diet or an underlying health condition.

B12 is one of the vitamins associated with peripheral neuropathy. If you’re deficient in vitamin B12, you may have some of the following symptoms:

  • fatigue
  • shortness of breath
  • dizziness
  • tingling and coldness in the hands and feet
  • headache
  • chest pain
  • digestive issues
  • nausea
  • an enlarged liver

Diagnosis and treatment

Your doctor will take a medical and family history, complete a physical exam, and draw blood to determine if you have a vitamin deficiency.

You may need supplements or another treatment, depending on the cause of your low vitamin levels.

Medication use

Tingling in the feet can be a side effect of some medications. The most common drugs that cause this sensation are those used to treat cancer (chemotherapy) and those used to treat HIV and AIDS.

Others include medications used to treat:

Treatment

If you’re taking a medication and experiencing tingling in your feet, speak with your doctor. They’ll be able to determine if the tingling is a side effect of your medication. They’ll also decide whether your dose needs to be changed.

Pinched nerve

A pinched nerve in your back can cause tingling in your feet. Pinched nerves may be due to injury or swelling.

In addition to tingling, you may also experience:

  • pain
  • changes in the sensation in your feet
  • decreased range of motion

Diagnosis and treatment

Your doctor will complete a medical history and physical exam to determine if you have a pinched nerve. They may also complete an EMG to look at muscle activity or a nerve conduction study. Other tests may include an MRI or ultrasound.

Treatment for a pinched nerve may include:

  • rest
  • medication
  • physical therapy
  • surgery, in some cases

Toxin exposure

Exposure to certain chemicals and toxins can cause tingling in the feet. Toxin exposure may also cause:

  • pain
  • numbness
  • weakness
  • difficulty walking

Some toxins that can cause tingling in the feet if they’re swallowed or absorbed through the skin are:

Diagnosis and treatment

It can be difficult to diagnose toxin exposure as the cause of tingling in the feet.

A healthcare professional will take a medical history, including details about your work and home environment, your diet, and any supplements you take.

They may also perform other tests, including blood tests.

Treatment may include medications, new safety measures, and changing your environmental exposure to toxins at work or at home.

Hyperventilation

Hyperventilation occurs when you breathe too deeply and rapidly. It causes a decrease in carbon dioxide in your blood, which can make you feel lightheaded, short of breath, and anxious.

Decreased carbon dioxide levels can also cause a tingling sensation in your feet or hands.

Hyperventilation isn’t a disease itself. It’s a symptom of emotional stress or other conditions such as:

Diagnosis and treatment

If you’re hyperventilating, a healthcare professional will ask you about your other symptoms and medical history. They may also give you a physical exam and use blood tests to check for certain conditions, such as infections.

Treatment for hyperventilation requires addressing the underlying condition that’s causing the hyperventilation.

Home remedies to treat a hyperventilation episode aim to slow down your breathing and increase your body’s carbon dioxide levels.

Here are some techniques to try:

Unknown causes

Sometimes people experience tingling in their feet and there’s not a known cause. Doctors call this “idiopathic.”

Idiopathic tingling is most common in people over 60 years old. In addition to tingling, you may experience:

  • pain
  • numbness
  • weakness
  • unsteadiness when standing or walking.

Diagnosis and treatment

A healthcare professional will complete a physical exam and perform a number of tests to rule out anything that could be causing your symptoms.

Treatment may include pain medication, safety measures, and special shoes.

See a doctor if you experience tingling in your feet that:

  • doesn’t go away
  • gets worse
  • is accompanied by pain
  • keeps you from walking well

You may be at risk for falls if you can’t feel your feet properly.

If you experience tingling in your feet accompanied by a severe headache, tingling in your face, or sudden weakness, get immediate medical attention. These may be signs of a stroke, which can be life threatening.