Temporary pins and needles
Sitting on your feet, crossing your legs or wearing tight shoes can press on nerves and reduce their blood supply. The foot may go numb and then tingle as it wakes up. This is called paraesthesia and is harmless if it settles within minutes of moving.
Tingling that happens often in the same position, or takes longer to settle, can be an early sign of nerve irritation.
Tingling in one foot
- Sciatica and lumbar nerve roots: tingling with back, buttock or leg pain; see lumbar radiculopathy and pinched nerve in the lower back.
- Tarsal tunnel syndrome: tingling and burning in the sole and inner ankle from compression of the tibial nerve.
- Morton’s neuroma: tingling or numbness between the toes; see Morton’s neuroma.
- Peroneal nerve compression: tingling on the top of the foot, sometimes with weakness lifting the foot, after crossing the legs or weight loss.
- Injury: after ankle sprains or fractures.
Tingling in both feet: peripheral neuropathy
When the long nerves to the feet are damaged, symptoms usually start in the toes of both feet and slowly spread upwards in a stocking pattern. People describe tingling, burning, numbness, pain at night or a feeling of walking on cotton wool. Balance can worsen, especially in the dark.
Common causes include diabetes, low vitamin B12, alcohol, some chemotherapy and other medicines, kidney disease, an underactive thyroid and some infections and autoimmune conditions. In some people no cause is found.
Diabetes and the feet
Diabetes is the most common cause of peripheral neuropathy. Good blood sugar control slows nerve damage. Because numb feet may not feel injuries, people with diabetes should check their feet daily for cuts, blisters and colour changes, wear well-fitting shoes and attend regular foot checks.
A wound on the foot that does not heal, or a foot that becomes red, hot and swollen, needs urgent assessment.
Vitamin B12 and other deficiencies
Vitamin B12 is essential for nerves. Deficiency is more common in older adults, vegans and vegetarians who do not take supplements, people with stomach or bowel conditions and those taking metformin or long-term acid-lowering medicines. It can cause tingling in the hands and feet, tiredness, memory problems and a sore red tongue.
A blood test can confirm it, and treatment with injections or tablets can improve symptoms, especially when started early.
How tingling in the feet is investigated
- History and examination: sensation, reflexes, strength, balance and the feet themselves.
- Blood tests: blood sugar, vitamin B12, folate, kidney, liver and thyroid function.
- Nerve conduction studies: measure how fast and how strongly nerves carry signals.
- Electromyography (EMG): a fine needle records the electrical activity of muscles, showing whether nerves or muscles are affected.
- Imaging: an MRI of the spine if a nerve root problem is suspected.
These tests help distinguish nerve root compression, nerve entrapment and peripheral neuropathy, which are treated differently.
What helps
- Treat the cause, such as blood sugar control or B12 replacement.
- Change position often and avoid crossing the legs for long periods.
- Wear comfortable, roomy shoes.
- Stay active: walking and balance exercises help circulation and stability.
- Limit alcohol.
- Medicines for nerve pain can be prescribed if burning or pain affects sleep.
Physiotherapy helps with balance, strength and nerve-related back problems. See also why do my feet hurt.
When to seek help
- Sudden tingling or numbness with weakness on one side of the body, facial drooping or difficulty speaking: call emergency services.
- Tingling in both legs with back pain, numbness around the genitals or bladder or bowel problems: go to A&E.
- Weakness, foot drop or frequent falls.
- Tingling that persists, spreads or keeps coming back.
- A foot wound that does not heal, especially with diabetes.
Key points to remember
- Brief pins and needles after sitting are harmless.
- Tingling in one foot often comes from the back or a trapped nerve.
- Tingling in both feet suggests neuropathy, often from diabetes or low B12.
- Blood tests and nerve studies such as EMG help find the cause.
Questions about tingling in the feet
These answers are general information and do not replace an examination or individual medical advice.
When should I worry about tingling in my feet?
If it persists, affects both feet, spreads, or comes with weakness, balance problems or wounds.
Can anxiety cause tingling in the feet?
Anxiety and hyperventilation can cause tingling, usually in the hands and around the mouth, but persistent foot tingling should be checked.
What vitamin deficiency causes tingling in the feet?
Vitamin B12 deficiency is the most common; folate and, less often, other vitamins can also contribute.
Is tingling in the feet a sign of diabetes?
It can be. Diabetes is the most common cause of neuropathy in the feet.
What is an EMG test?
A test that records the electrical activity of muscles with a fine needle, usually done with nerve conduction studies.
Can a back problem cause tingling in the feet?
Yes. A trapped nerve in the lower back can cause tingling in one foot.
Sources
- NHS · Pins and needles
- NHS · Peripheral neuropathy
- NHS · Vitamin B12 or folate deficiency anaemia
- MedlinePlus (NIH) · Numbness and tingling
- MedlinePlus (NIH) · Electromyography
This guide is for general information and does not replace medical advice. How a problem is diagnosed and treated depends on your examination and medical history. If you think you have an emergency, contact your local emergency services.