Heel tingling, or paresthesia, is a common sensation. While often temporary, it can sometimes signal an underlying health issue. Understanding its causes helps determine when medical attention is needed.
Everyday Reasons for Heel Tingling
Heel tingling often results from daily activities that temporarily affect nerve function or blood flow. Sustained pressure on the foot, like sitting with crossed legs or wearing tight footwear, can compress nerves. Restricted blood circulation to the heel can also cause tingling.
Ill-fitting shoes are a frequent culprit, creating pressure points or restricting foot movement. High heels, for instance, can irritate nerves by increasing pressure on the front of the foot. Minor nerve compression from positions like prolonged kneeling or squatting also causes transient tingling. This sensation usually subsides once pressure is relieved and blood flow returns.
Medical Conditions Causing Heel Tingling
Persistent or recurring heel tingling may indicate underlying medical conditions affecting nerves or circulation. Nerve entrapment syndromes are a notable cause, especially tarsal tunnel syndrome. This involves compression of the tibial nerve inside the ankle, often due to swelling, growths, or flat feet, causing tingling, burning, or numbness in the heel and sole.
Peripheral neuropathy, nerve damage affecting the extremities, commonly causes tingling and numbness in the feet and legs. Diabetes is a frequent cause, as high blood sugar levels can damage nerves over time. Other systemic conditions contributing to neuropathy include vitamin deficiencies (especially B12), alcoholism, and an underactive thyroid.
Sciatica, caused by compression or irritation of the sciatic nerve in the lower back, can cause symptoms radiating down the leg to the foot, including tingling. Numbness and tingling in the heel or sole are common with sciatica, though pain is often present. Direct injury or trauma to the heel or ankle can also cause persistent tingling. Less common causes include infections like Lyme disease, HIV, or shingles, which can inflame nerves.
Signs That Warrant Medical Attention
While temporary heel tingling is often harmless, certain signs warrant medical evaluation. Seek professional assessment if tingling is persistent, doesn’t resolve with position changes, or worsens. Tingling with pain, numbness, or weakness in the foot or leg also requires a doctor’s visit.
A medical professional should also evaluate tingling that spreads or occurs after an injury. Other concerning symptoms include difficulty balancing, gait changes, or if tingling is associated with systemic issues like unexplained weight loss or fever.
Understanding Diagnosis and Treatment
Diagnosing heel tingling begins with a physical examination and medical history review. A healthcare provider will inquire about symptom nature, onset, progression, lifestyle factors, and existing conditions. This initial assessment helps narrow down causes and guides further investigation.
Depending on the suspected cause, diagnostic tests may be recommended. Nerve conduction studies and electromyography (EMG) assess nerve function and identify damage or compression. Blood tests check for underlying conditions like diabetes, vitamin deficiencies, or thyroid disorders. Imaging studies like X-rays or MRI visualize structural issues, such as nerve compression from bone spurs or herniated discs.
Treatment for heel tingling depends on the diagnosis. For mild cases, lifestyle adjustments like proper footwear, orthotics, and rest can help. Physical therapy may improve flexibility, strength, and nerve mobility. Medications, including over-the-counter pain relievers, anti-inflammatory drugs, or nerve pain medications, can manage symptoms. In severe nerve compression or when conservative treatments fail, surgery to decompress the nerve may be considered.