Numbness in your heel, often described as tingling or pins and needles, is a common sensation. Medically known as paresthesia, it usually results from factors that briefly interrupt nerve signals. Understanding its causes can help in addressing it effectively.
How Numbness Happens in Your Heel
Sensation in your heel is conveyed through a network of nerves. The tibial nerve, a major nerve running down the back of your leg, plays a primary role, branching into the medial plantar, lateral plantar, and medial calcaneal nerves. These branches supply sensation to different parts of the heel and sole of the foot. When these nerves are subjected to pressure, injury, or other disruptions, their ability to transmit electrical impulses is hindered, leading to altered sensations like numbness or tingling.
The tarsal tunnel, a passageway along the inner ankle, houses the tibial nerve and its branches, along with tendons and blood vessels. Compression or irritation within this tunnel can disrupt nerve function, leading to numbness. Pressure from external factors or internal swelling can also impede blood flow to the nerves, depriving them of oxygen and nutrients, which contributes to numbness.
Common Causes of Heel Numbness
A frequent cause of heel numbness is prolonged pressure on the nerves. Sitting with crossed legs for extended periods or wearing shoes that are too tight can compress nerves and blood vessels, leading to temporary numbness, often described as a foot “falling asleep.” This type of numbness usually resolves once the pressure is removed.
Injury to the foot can also result in heel numbness. Swelling or bruising from an injury can compress nearby nerves, disrupting nerve function. Repetitive stress can also inflame surrounding muscle and tissue, restricting nerve pathways.
Nerve entrapment syndromes in the foot are another common cause. Tarsal tunnel syndrome occurs when the tibial nerve becomes compressed within the tarsal tunnel due to swelling, injury, or anatomical variations like flat feet. This can lead to numbness, tingling, or burning sensations in the heel and bottom of the foot. Baxter’s neuropathy, another specific nerve entrapment, involves compression of the inferior calcaneal nerve, often leading to numbness and pain in the heel.
Nerve irritation can also arise from conditions like plantar fasciitis, an inflammation of the thick band of tissue along the bottom of the foot. While primarily known for heel pain, severe or chronic plantar fasciitis can sometimes lead to nerve irritation, contributing to numbness in the heel area if inflamed tissue presses on nearby nerves.
When Numbness Signals Something More Serious
While heel numbness is often a temporary occurrence, it can sometimes indicate a more significant underlying health issue. Numbness accompanied by weakness in the affected foot or leg, or if it spreads to other areas, is a concern. Sudden onset of severe numbness or numbness that progressively worsens should also prompt medical attention.
Radiating pain from sciatica can cause numbness in the heel. Sciatica occurs when the sciatic nerve, which extends from the lower back down the leg, becomes irritated or compressed, often by a herniated disc. This can result in sharp, burning pain, tingling, and numbness that travels along the back of the leg, potentially affecting the foot and heel.
Numbness after a significant injury, such as a fracture or dislocation of the ankle, warrants immediate medical evaluation, as it could indicate nerve damage or compromised blood flow. Systemic conditions can also manifest as heel numbness. Diabetes-related neuropathy, a common complication of diabetes, involves nerve damage due to persistently high blood sugar levels, often affecting the nerves in the feet first and causing numbness, tingling, or burning sensations.
Multiple sclerosis (MS), a condition affecting the brain and spinal cord, can also cause numbness and tingling in various body parts, including the feet. In MS, numbness can range from mild to severe and may be accompanied by other symptoms like balance issues or muscle weakness. Additionally, certain vitamin deficiencies, particularly a deficiency in vitamin B12, can lead to nerve damage and symptoms like numbness or tingling in the hands and feet.
Managing Heel Numbness and When to See a Doctor
For mild heel numbness, several self-care measures can provide relief. Resting the foot by avoiding activities that aggravate the numbness, such as prolonged standing or running on hard surfaces, is beneficial. Applying an ice pack to the affected heel for 15 to 20 minutes, two to three times a day, can help reduce inflammation and discomfort.
Other self-care measures include:
- Massaging the heel to improve circulation and alleviate tingling.
- Soaking the feet in warm water, possibly with Epsom salts, to soothe nerves and muscles.
- Wearing properly fitting shoes with adequate arch support and cushioning, and avoiding tight footwear that compresses nerves.
- Incorporating regular foot stretches and low-impact exercises like swimming or walking to enhance circulation and muscle tone.
Seek medical consultation if heel numbness persists for more than a few days, worsens over time, or is accompanied by other concerning symptoms. Also see a doctor if the numbness follows a significant injury, or if it presents alongside weakness, severe pain, or unexplained symptoms.
During a medical examination, a healthcare provider will review your symptoms and medical history, including any existing conditions or previous injuries. They may perform a physical examination of your foot and ankle, which could involve tapping the nerve to check for a tingling sensation, known as Tinel’s test. Diagnostic steps might include nerve conduction studies (NCS) and electromyography (EMG) to assess nerve and muscle function, or imaging tests such as X-rays or MRI to identify potential causes like nerve compression or structural abnormalities. Treatment approaches will vary based on the diagnosis and may include physical therapy, specific medications, lifestyle adjustments, or, in rare severe cases, surgical decompression of the affected nerve.