Burning, Numbness & Tingling in Feet or Toes?

 What Does say

Tom neckey 

Of

Michigan Foot Doctors

I am going over  numbness burning tingling at the bottom of   your foot so if you have numb feet tingling feet  burning feet i'm going to go over the most likely  

things that are causing this and exactly what to  do about it i have the benefit of seeing probably  

thousands of patients and this is one of the most  common things i see look at all the nerves down  

here underneath your big toe joint underneath your  toes underneath the ball of your foot right here  

on your heel right here there's nerves on the  inside of your ankle there's nerves and on the  

outside of your ankle there's nerves i'm going to  touch on all of these what's most likely causing  

it and what to do about it so if you're living in  pain if you're worried if this is getting worse  

we're gonna guide you on what you should  probably do but here's the disclaimer  

nerve diseases are tricky there's a  million different things that could happen  

this would cover the most practical ways on what  to do about it but always rely on your doctor so  

let's start getting that foot pain  better and we're starting right now

so there's a lot of different causes there's  nerve diseases there's systemic problems and  

then there's biomechanical problems there's  ways to practically approach all of these  

and at the very end i'm going to give you very  practical solutions to get this problem fixed  

because you should not be living with numbness  burning and tingling it's not normal nerve pain  

and nerve disease are not normal and the majority  of the time there is a lot of things you can do  

to get it better and for most of my patients i  would expect them to get significantly if not all  

the way better so here's what we're starting  with there's a condition called peripheral  

neuropathy and what peripheral neuropathy means  is peripheral means your hands and your feet  

and neuropathy means nerve and pathy means  problem so it's nerve problem what does that mean  

absolutely nothing it means in your hands and  feet you have a problem there's about a hundred  

different documented causes and i'm going to list  off the most common ones number one is diabetes  

so this is the one we always look for a  good chunk of my patients are diabetics  

so what that means is poor feeling in the feet  poor feeling in the ball of the foot the toes you  

can develop wounds you can get aching at nighttime  throbbing this can also happen with people who  

drink alcohol this can also happen with people who  have thyroid problems this can happen with people  

who have vitamin deficiencies and nutritional  deficiencies so here's what you do in this case  

in almost all of these and the next few are  you know aging health problems a million other  

things toxin deficiencies cancer therapies  radiations medications here's what you do  

for all these number one for systemic problems  you have to get to the root cause of this so  

what this usually means is going to see your  podiatrist hey that's me and if you're in the  

michigan area we would love to help we work with  internal medicine doctors podiatrists this is one  

of the things we specialize in but what you need  to do in this case is a lot of the times it is  

biomechanical issues and we'll go over that but  you might need a history and physical you might  

need blood tests sometimes on a blood test people  have anemia they have poor blood flow that's why  

they're numb you know they could have some type  of vitamin deficiency they could have a lot of  

different problems and it has to be diagnosed  it's hard to diagnose some of these accurately  

online that's why it's always recommended to come  see your podiatrist so with all these tests we  

can do more specific tests in person we use a  tuning fork to check your vibration sensation  

we use a fine instrument called a sems weinstein  monofilament to check if you have sensation in  

your toes your feet when we compare it what's it  like in the rest of your body and what we can then  

do is get x-rays to see if there's biomechanical  issues that could be impinging nerves we could get  

mris to see if it's impinged ultrasounds to see  if it's impinged i can work this up in person a  

c by pressing on these areas or doing a nerve  injection to see if the nerves injured somehow  

but don't worry i'm not just going to tell you to  go see your podiatrist there is going to be some  

options here but if you're concerned after already  seeing a podiatrist like some of our patients are  

nerve conduction velocity tests emg tests more  advanced tests are available assess your back for  

pinched discs impinge discs and i'm going to put  a video right here where i talk about this stuff  

for 30 minutes you know the vitamin deficiencies  everything but the real key for these solutions  

are get as healthy as possible i'm always a  big fan of weight loss the bottom line is it's  

not normal to have this stuff get as healthy as  possible clean up your diet as much as possible  

eat your vitamins your daily multivitamin make  sure you get enough sunlight vitamin d so there  

are a lot of vitamins and i talk about some of  them in my other videos here the bottom line is b  

vitamins are really good there's about seven or  eight proven vitamins but the bottom line is the  

majority of the rest are kind of fluff there's not  a lot of evidence behind some of these even though  

people always have stories about what works or  not but then implants work like spinal stimulators  

i work with pain management specialists if all  this does not work and it is a systemic disease  

a spinal stimulator can work medications for  pain nerve blocking medications so spinal  

stimulators can work really well a lot of pain  management physicians do this that i work with  

so that's kind of the end of the line  but what we want to do earlier is  

if you're having a lot of pain it might be easier  to get on nerve blocking medications so these are  

like the lyricas the gabapentins there's creams  you can put on your feet so creams you want to  

start off with are biofreeze can work really  good capsaicin can work really good there's a  

lot of great creams out there specifically i like  biofreeze you put it on your toes and it kind of  

short circuits your nerves so that you can sleep  better but don't worry there's better solutions  

the next thing you want to do is address  biomechanical issues and i'm going to show  

you specifically how to address these later but  what happens is what if you're numb in the big toe  

joint or the ball of the foot these are usually  pressure injuries called metatarsalgia or morton's  

neuroma i'm going to link down here a video  where i talk for about 25 minutes about morton's  

neuroma because there's a lot of detail here but  these are the nerves in the bottom of your foot  

i'm not going to get into the specifics but if  the bottom of the front of your foot is aching  

think about morton's neuroma treatment and that's  the video i just linked or down in the show notes  

is the links to all these videos as well check  it out there's a lot of easy solutions such as  

injections therapies orthotic shoes that can help  with ball of the foot pain i'll go over some of  

them towards the end of the video if it's not  the front of your foot if it's your heel there's  

something called baxter's nerve entrapment so you  could have nerve pain in your heel so at nighttime  

if it's aching it's throbbing or when you get  up in the morning that's aching and throbbing  

that could be back sister's nerve impingement  or it could be aching tendinitis as well i go  

over it in this video below for a very long time  i can't get into it in all this video but same  

kind of thing pain relief massaging stretching  offloading make sure that nerve gets unimpinged  

so uh we couldn't do tests like an emg or an  ncs nerve conduction study and these tests can  

really show if that's where the impingement is  but again i show that down in this video the next  

most common thing is on the inside of the ankle  just like carpal tunnel in your wrist you can get  

something called tarsal tunnel so tarsal tunnel  on the inside of the ankle what happens here  

is this is the most common one if the bottom of  your foot gets aching numb and sore in the front  

this could be tarsal tunnel syndrome so tarsal  tunnel syndrome is like carpal tunnel when your  

foot flattens out too much so so watch this  when i push down on this see how it flattens  

see the back right here how much it's flattened  those nerves on the inside of the foot and the  

ankle they can really compress and what happens is  it's like taking a rope and stretching it when you  

stretch that rope the nerve goes numb it's kind of  like the bottom of your foot falling asleep this  

is the cause in most people they're so flat-footed  that what happens is that nerve goes numb  

so what happens then is the fourth thing so  on the outside of your foot right here if your  

foot's compressing it can compress those nerves in  the sinus tursi region which is right here that's  

called sinus tarsitis and that can cause numbness  burning and tingling as well so those are the four  

most common spots combined with peripheral  neuropathy so the big issue is biomechanics  

the same biomechanical principles contribute  to all of these so here's what i mean by that  

this is what i mean by biomechanics and this will  explain a little bit better look at my left foot  

it's less flexible than my right foot by about 10  degrees i've pre-measured it see that right there  

the angle really makes a big difference so my leg  has to turn out that stretches the inside of my  

ankle and compresses the outside of my ankle see  this right here see that flexibility difference  

this one can bend up whereas this one can't  really bend up there's a 10 degree difference  

that makes that left foot need to turn out almost  every patient i see is like this look at this  

healthy young gentleman as he's running his feet  don't have to buckle out he's equally flexible his  

feet land fairly straight and the feet aren't  really twisting out on the leg but take a look  

at this leg it looks a little bit more sloppy but  what happens is the inside of the ankles collapse  

in and the outside of the ankles collapse  and compress i should say not collapse that  

stretches the nerves on the inside and crushes the  nerves on the outside take a look at this older  

gentleman he's less flexible his calf muscles his  hamstrings are not flexible the front of his foot  

impacts more that's more nerve injury that's more  bruising and more tension throughout his tendons  

initially in the mornings you want to grab some  massage equipment and some icing i love to freeze  

a water can but make sure it doesn't explode a  water bottle might be better and just massaging  

the bottom of your feet this won't cure your  nerve bruising but it can make it feel better so  

see that's a frozen ice ball right there it's not  great for the bottom of the foot but great for the  

calf muscle right there even massage balls this  loosens up your ligaments and your tendons in one  

minute basically you can loosen up your muscles  and your tendons on the bottom of your foot making  

them feel better this won't make it go away right  away that's why creams like biofreeze which are  

linked below as some options are effective there's  a lot of different pain creams anti-inflammatory  

creams compound creams that your doctor can  help you with pills can help like gabapentin  

and lyrica but i don't really recommend those  get to the root cause of the problem that's  

really what will make the big difference long term  you don't want to just rely on medications because  

eventually they lead to more medications more  problems and learning to live with the problem  

rather than fix it so massaging a massage stick is  like ten dollars i'm a huge fan of this i do this  

every morning you want to do about a minute or  two of stretching every morning when you wake up  

so i do my calf muscles here nothing too painful  but get the meaty areas and you'll notice after  

like a minute 30 seconds how much you loosen  up it gets those tight stiff muscles looser  

and then you do some stretching if you can't reach  your toes you can use a towel kind of like i was  

shown there but after a massage instantly you get  more flexibility and what happens then you can use  

a towel to stretch and this i'm talking a couple  minutes every morning don't do a one-hour yoga  

although that's helpful too in shoes consider  those as well so the biggest thing here is  

watch this when i push down on the ground see how  much this ankle flattens out that means your knees  

are buckling in your feet are twisting out it's  straining your joints your muscles that makes  

you swell getting stronger muscles getting more  flexible will make a big big difference so this is  

where i love shoes and orthotics and they can make  a huge difference for you as far as slippers goes  

i'm a big fan of bionic slippers for women so  see for these types you have pretty nice built-in  

arches they're not really expensive they're like  in the 40 30 range but you can see the arch is  

pretty aggressive in most of these you can't  really go wrong with a brand like bionic so bionic  

is excellent bionic caters more towards ladies i  would say even though they do have some shoes i  

would recommend don't use them for shoes but kind  of like a house slipper to walk around the house  

they are fantastic there are better shoes you can  get though for men i would recommend something  

like a spenco so see they're just a little bit  more earth tones i kind of have this one up here  

in the corner that works really well so these  can work really well see they make slippers  

sandals my wife uses these she loves the siesta  slide so these are really good as well so spenco  

and bionic are great four shoes inside the house  if i had to pick just one go with the brooks ghost  

that's down in the show notes so you can see last  year's model is a little bit cheaper at about 109  

the new model the 14 is like 140. these are  phenomenal shoes if you can get an insole  

from your podiatrist and over-the-counter insole  and again down in the show notes or my favorite  

get a good brooks ghost uh get the insoles  we recommend down in the show notes it's  

going to really make a big difference  for you and the biggest thing you can do  

is get the swelling down as well all of this  swelling will stretch the nerves stretch the  

tissue and that can lead to some pain in the foot  and in the ankle and this can exasperate all those  

small nerve fibers so compression stocking  good socks and good brace can help with that  

there's different types of compression socks  so there's the knee-high ones that are over the  

counter there's knee-high ones prescribed  by a podiatrist like myself so they can  

be 20 millimeters mercury 30 millimeters of  mercury or 40 millimeters of mercury or more  

these ones that you buy over the counter are more  like 10 millimeters to 15 millimeters of mercury  

but what i would recommend is start off with  over-the-counter stuff the doctor stuff is hard  

to get and it's so tight and so uncomfortable that  you can barely move and it might not necessarily  

be good for you unless your doctor specifically  recommended it so as always i include some of my  

favorites some of the best rated ones but you  don't have to get anything from me you know uh  

these are not my products by any means so check  out some of these compression socks right here  

so you could see down here the different size they  actually do a good job showing you the different  

colors here but specifically what you want to look  at is they're not that expensive like eight pairs  

for seventeen dollars like i mean come on that's  like two dollars per pair of socks so it's like  

a dollar per sock that you can keep re-wearing so  you can kind of see uh these are meant to be more  

athletic there's some sizing guides but these are  marketed as nursing socks but the what i want you  

to look at is 15 to 20 millimeters of mercury this  is too low of compression for insurance to cover  

most adults that have swelling problems will not  be able to get on the 20 to 30 or 40 millimeter  

compression socks these are so tight that nobody  wears them in my experience everybody tries to  

buy them but maybe like two percent of people  actually wear them get something that's low cost  

so for like you know a dollar per pair here uh  that's lower compression if you find that it's  

not enough compression for you then get something  heavier don't goof around starting with like the  

40 millimeter mercury trying to get insurance  to cover it because you're going to jump through  

a lot of hoops you're going to waste a lot of  time and it's going to cut into your skin and  

you're going to hate it if you're like 98 of the  patients i see start with something low cost and  

lower compression see how it works see how it fits  into your routine and then go up to the higher  

compression at the same time take a look right  here the 20 to 30 millimeter mercury are like 15  

why would you waste time driving to like different  uh outlets waste and gas especially the price it  

is trying to exchange prescriptions from your  doctor to the medical supply company to get  

something like this when it's so cheap online  it just doesn't make a lot of sense to me and  

realistically you should go with the lower  compression this for the average person is  

probably a little bit too high and doesn't provide  a ton of benefit it'll cut into your skin and  

hurt you more than it will benefit you so start  with the lower compression rather than the high  compression down

 in the notes given in the description of the linked video as given at the bottom of this blog   And

 I also  included below for reference

Tingling in the feet, toes & legs is usually the symptom of nerve irritation or nerve damage. This can usually be reversible but may be related to a disease. 

We also discuss numbness in the toes, feet & legs related to biomechanics issues such as Morton's neuroma, nerve impingement, tarsal tunnel syndrome or Baxter's nerve impingement.

Burning in the feet, legs & toes can also be due to chronic nerve irritation or peripheral neuropathy. This means there can be an illness related to your peripheral nerves. This can be due to diabetes, alcohol, thyroid disease, cancer or cancer therapy, or more. There are 100+ known causes.

https://youtu.be/Pdp9HLH9Gsg