Numbness in your feet is a symptom of diabetic neuropathy — a common complication of type 2 diabetes.
It occurs when nerves in your body become damaged by high blood sugar levels. About half of people with diabetes will have some type of neuropathy, but there are steps you can take to prevent or slow nerve damage.
Diabetic Neuropathy and Numbness
Diabetic neuropathy is nerve damage that’s caused by the effects of diabetes. Neuropathy can cause numbness, tingling, burning, extreme sensitivity, or sharp pain in your feet. Symptoms are usually felt in both feet equally.
There are different types of neuropathy, including:
Peripheral NeuropathyPeripheral neuropathy occurs when nerves are damaged in the feet and legs, and less commonly the hands and arms.
Autonomic Neuropathy In autonomic neuropathy, the nerves in the autonomic nervous system are impacted. This system controls blood pressure, heart rate, sweating, eyes, bladder, and digestion.
Focal Neuropathies These conditions cause damage to single nerves, often in your hand, head, leg, or torso.
Proximal Neuropathy A rare type of neuropathy that affects the nerves in your hips, buttocks, or thighs.
For people with diabetes, peripheral neuropathy is the most common form of neuropathy and generally affects the feet and legs first.
“Overall, the experience of numbness in diabetic neuropathy can vary widely in intensity and quality, often significantly impacting daily life and functionality,” says Joel Zonszein, MD, an emeritus professor of medicine at the Albert Einstein College of Medicine Montefiore Medical Center in Bronx, New York.
Dr. Zonszein says blood sugar impacts your nerves in different ways. Specifically, when glucose levels get too high, they can cause:
Nerve damage: The accumulation of sugars can become toxic to nerve cells, which leads to damage.
Oxidative stress: High blood sugar can trigger oxidative stress, or an imbalance of free radicals and antioxidants in the body, which can result in nerve injury.
Inflammation: Chronic high blood sugar can lead to inflammation, which can then damage the nerves.
Demyelination: The myelin sheath that protects nerve fibers can become damaged due to high blood sugar levels.
Impaired blood flow: When blood sugar levels are too high, some people experience impaired circulation, which can impact nerve health.
How to Treat Foot Numbness and Pain
Early detection and treatment of neuropathy is important for preventing complications. Foot numbness is a common symptom of peripheral neuropathy and happens because high blood sugars injure blood vessels and nerves over time.
“The numbness is caused by damage to the longest nerves in your body, which are the ones that go to your toes,” explains Brian Callaghan, MD, PhD, a professor of neurology at University of Michigan Medical School in Ann Arbor.
“Neuropathy can lead to ulcers in the feet, collapsing of the foot and ankle, and some patients even need amputations,” explains Dr. Callaghan.
An accurate diagnosis is essential, stresses Zonszein. He says your doctor needs to rule out other potential causes, such as hip problems, lower back pain, spinal stenosis (a condition that causes spaces in your spine to narrow), or a pinched nerve. Once a correct diagnosis is established, treatment and prevention strategies can begin.
Blood Sugar Control
“The most important aspect of managing diabetic neuropathy is maintaining optimal blood glucose [blood sugar] levels,” says Zonszein.
Good blood sugar control can prevent or slow the progression of nerve damage. It may also improve some of your current neuropathy symptoms.
Some ways to keep blood sugar levels under control include:
Follow a healthy diet. Focus on eating more vegetables, fruits, whole grains, and lean proteins. Avoid processed foods and those that are high in saturated fat, sugar, or salt.
Exercise. Regular physical activity can burn off excess sugar and keep your body weight under control.
Lower stress levels. Relaxation exercises like meditation and yoga can help you manage your stress.
Get adequate sleep. Poor sleep is linked to higher blood sugar levels.
Stay hydrated. Drink water instead of juice or soda. Also, avoid alcohol.
Track your blood sugar. Keep a log of your blood sugar levels to figure out what makes them go up or down.
Take your meds. Take diabetes medications as prescribed by your doctor.
The American Diabetes Association recommends that people with diabetes have a test called a hemoglobin (A1C) at least twice a year. Your A1C tells you your average blood sugar level over the previous two to three months.
Medication
Some medications can alleviate the pain of neuropathy. Your doctor might suggest:
Antidepressants, such as duloxetine (Cymbalta), amitriptyline (Elavil), nortriptyline (Aventyl), desipramine (Norpramin), imipramine (Tofranil) or venlafaxine (Effexor)
Anticonvulsants, such as gabapentin (Gralise, Neurontin) or pregabalin (Lyrica)
Capsaicin (Qutenza) When capsaicin cream is applied to the skin, it can dull pain sensations.
Skin creams, patches, or sprays that contain lidocaine
While these medicines might help with the pain, they won’t reverse nerve damage.
“When prescribed, I give a low dose, and if there's no improvement, I will discontinue,” says Zonszein. You should consult with your doctor about which medication is right for you.
Devices
Spinal Cord Stimulation The U.S. Food and Drug Administration (FDA) has approved electronic stimulation of the spinal cord. Electrodes are implanted in the spinal cord and a power source is used to deliver an electrical current. This helps to lessen the perception of pain.
Complementary Therapies
Complementary therapies or home remedies can be used to relieve the discomfort of foot pain and numbness. Not all of them are backed by scientific research. You should always talk to your doctor before trying any new treatment.
“Some patients explore [complementary therapies] for symptom relief, though results can vary. In my experience, these have not been very successful,” says Zonszein.
Some popular methods include:
Acupuncture Acupuncture involves inserting needles into specific points in the body. For some, it may help relieve nerve pain.
Transcutaneous Electrical Nerve Stimulation (TENS) TENS distributes small electrical impulses to nerves via electrodes on your skin. The idea is to stop pain signals from reaching your brain.
Massage A relaxing massage can help some people with nerve pain feel better.
Alpha-Lipoic Acid This antioxidant is found in certain foods. It may alleviate nerve pain in some people.
Acetyl-L-Carnitine It’s a nutrient that’s available as a supplement to ease nerve pain.
Elevation Elevating your feet may relieve pain.
Benfotiamine This is a synthetic form of vitamin B1. Research suggests it may lessen inflammation and nerve pain.
L-Methylfolate (LMF) LMF is a form of folate. Some studies have found this supplement has a beneficial effect on people with diabetic neuropathy.
Methylcobalamin This activated form of vitamin B12 may alleviate pain associated with diabetic neuropathy.
Pyridoxal 5-Phosphate (PLP) It’s the active form of vitamin B6. Research suggests it could play a role in managing nerve damage symptoms, especially when patients have a deficiency or a surplus of vitamin B6.
Cannabis Limited research has suggested that inhaled or smoked cannabis can reduce symptoms of neuropathy.
Diabetes and the Importance of Foot Care
Neuropathy in your feet can put you at risk for other complications. When you have numbness in your feet, you’re more likely to develop open sores, which are called ulcers. The numbness can make it difficult to realize that you have an injury.
If untreated, diabetic ulcers can lead to infection or poor healing. If the problem is severe, amputation may be necessary.
In the United States, between 14 and 24 percent of people who develop a foot ulcer require amputation.
“The key is to address the underlying cause [of the numbness], treat any pain, and regularly check your feet for injury,” says Callaghan.
Here are some ways to take care of your feet if you have neuropathy.
Have a comprehensive foot exam at least once a year.
Check your feet for blisters, cuts, bruises, peeling skin, redness, or swelling every day.
Keep your feet dry and clean.
Moisturize your feet to prevent cracking. But avoid putting lotion between your toes, as this can promote the growth of fungus.
Trim your toenails with care.
Wear dry, clean socks.
Wear closed-toe shoes to protect your feet. Also, make sure your shoes fit and are well-cushioned.
Questions to Ask Your Doctor
Is diabetic neuropathy the cause of my numb feet?
Do I need any tests to confirm that I have diabetic neuropathy?
If I control my blood sugar, will my symptoms go away?
Can you provide me with educational materials to help me better understand my condition?
What are the best ways to improve my A1C?
What treatments do you recommend to help foot pain or numbness?
Would complementary therapy help my symptoms?
Do I need to see a specialist for my nerve issues?
The Takeaway
Foot numbness is a common symptom of diabetic neuropathy, which happens when high blood sugar levels damage nerves.
Neuropathy can cause numbness, pain, tingling, burning, sensitivity, and loss of sensation.
Controlling your blood sugar levels is the best way to prevent foot numbness and slow the progress of nerve damage.
Various treatments and complementary approaches are available to ease the discomfort of nerve pain.
Elise M Brett, MD, is a board-certified adult endocrinologist. She received a bachelor's degree from the University of Michigan and her MD degree from the Icahn School of Medicine at Mount Sinai. She completed her residency training in internal medicine and fellowship in endocrinology and metabolism at The Mount Sinai Hospital. She has been in private practice in Manhattan since 1999.
Dr. Brett practices general endocrinology and diabetes and has additional certification in neck ultrasound and fine-needle aspiration biopsy, which she performs regularly in the office. She is voluntary faculty and associate clinical professor at the Icahn School of Medicine at Mount Sinai. She is a former member of the board of directors of the American Association of Clinical Endocrinology. She has lectured nationally and published book chapters and peer reviewed articles on various topics, including thyroid cancer, neck ultrasound, parathyroid disease, obesity, diabetes, and nutrition support.
Julie Marks is a freelance writer with more than 20 years of experience covering health, lifestyle, and science topics. In addition to writing for Everyday Health, her work has been featured in WebMD, SELF, Healthline, A&E, Psych Central, Verywell Health, and more. Her goal is to compose helpful articles that readers can easily understand and use to improve their well-being. She is passionate about healthy living and delivering important medical information through her writing.
Prior to her freelance career, Marks was a supervising producer of medical programming for Ivanhoe Broadcast News. She is a Telly award winner and Freddie award finalist. When she’s not writing, she enjoys spending time with her husband and four children, traveling, and cheering on the UCF Knights.
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Didangelos T et al. Vitamin B12 Supplementation in Diabetic Neuropathy: A 1-Year, Randomized, Double-Blind, Placebo-Controlled Trial. Nutrients. January 27, 2021.
Muhamad R et al. The Role of Vitamin B6 in Peripheral Neuropathy: A Systematic Review. Nutrients. June 21, 2023.
Modesto-Lowe V et al. Cannabis for peripheral neuropathy: The good, the bad, and the unknown. Cleveland Clinic Journal of Medicine. December 2018.
