Pain and numbness on top of foot

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If you lose feeling in your foot or toes due to a funky positioning at the movie theaters, it’s easy to pinpoint what’s wrong (and how to fix it). Other times? Tingling and numbness can be a bit more confusing—and a little bit scarier. What is going on down there?

Often, if you’re feet are feeling prickly or your toes are straight up numb, nerves—bundles of fibers that help to transmit motor and sensory info throughout the body—are involved. Pressure on them, irritation of them, damage to them—it can all lead to a lack of feeling in your dogs. Here, common reasons even healthy guys might have less sensation than normal and what to do if you notice the symptom.

1

Your shoes are too damn tight.

Squeezing into uncomfortable loafers day in and day out for a decade? “Dress shoes are tighter and therefore compress the foot, which, in turn, compresses the nerve,” explains Ettore Vulcano, M.D., chief of foot and ankle surgery at Mount Sinai West in New York City. And when a nerve is compressed, you can feel pins and needles. Look for shoes that are wide enough so that your feet are comfortable, not squashed; after a few days, you should regain business-as-usual foot feeling.

Got tingling and numbness on just the tops of your feet? Loosen the laces on your sneaks. “There are superficial nerves on the tops of our feet that are susceptible to trauma from laces pressing on the area,” says Brian Fullem, D.P.M., a sports podiatrist in Clearwater, FL. “Try to skip crossing the shoelace over the highest part of your foot,” says Fullem.

That bony bump on your big toe joint ain’t pretty—and it could be causing bigger problems, too. Over time, as your big toe pushes against the rest of your toes (causing the bunion), you’re overloading and squeezing your adjacent toes (especially number two), Vulcano says.

The result? Nerve compression. A toe spacer can take the pressure off, Vulcano says. And often, changing your shoes, using orthotics, or icing can help. But if you’re still having pins and needles, see an orthopedic surgeon. Sometimes, surgery’s necessary.

3

You have a herniated disc.

Weightlifters and athletes who’ve recently overdone it and notice tingling toes may have a herniated disc, which happens when the rubbery cushions (discs) in your spine push into the spinal canal, irritating nearby nerves. “The sciatic nerve runs from the lower back to the toes,” Vulcano says.

If this is the culprit you’d also likely feel some serious low back pain and weakness in your feet, ankles, or legs. An X-ray or MRI can ID a herniated disc. From there, treatment could run the gamut from taking it easy to surgery.

4

You’ve irritated a nerve big time.

Numbness and even shooting pain in one or two toes (usually the third and fourth) could be caused by a neuroma, a.k.a. an irritated nerve, Fullem says. Telltale signs: feeling like you’re walking on a pebble or like you have a won’t-go-away pain on the ball of your foot. Running (or any high-impact sport for that matter) or tight ski boots or hiking shoes (that compress the nerve could be to blame, too. Opt for shoes that are wider in the front or, to alleviate pressure, try an insert called a metatarsal pad (that goes on the ball of your foot), Fullem advises.

Still in pain? Worst-case scenario, you’ve got scar tissue and may need surgery to have the enlarged nerve removed, Vulcano says, so get yourself to the doctor.

Neuropathy, a chronic nerve condition, is a common complication of other health issues such as alcoholism (which can interfere with the metabolism of vitamins essential to nerve health) and even medical treatments such as chemotherapy, says Vulcano.

It’s best treated by figuring out what the underlying cause is first—but also requires you see a neurologist who can prescribe nerve pain medications, says Vulcano. “Neuropathic patients should carefully examine their feet—above, under, behind—daily for ulcerations, as neuropathy is a risk factor for the development of skin breakdown.”

6

You have tarsal tunnel syndrome (TTS).

As in, the foot-version of carpal tunnel syndrome. When the nerve in the tarsal tunnel—a space in your foot on the inside of your ankle—is compressed, heel and arch pain along with numbness and tingling can ensue, says Fullem. It’s fairly uncommon, says Fullem, but can be caused by poorly-fitting shoes (it’s really time to give your footwear some thought), trauma, or lower body swelling (think: you sprained your ankle). OTC arch support and calf stretches can help, says Fullem.

Chronic levels of high blood sugar can damage your nerves and cause tingling in your feet and legs—a condition called peripheral neuropathy. Roughly half of the people with diabetes experience this symptom, according to WebMD.

If the numb feeling is accompanied by extreme fatigue, thirst, and frequent urination, you may want to talk to visit the doctor who can assess your diabetes risk.

Cassie Shortsleeve Freelance Writer Cassie Shortsleeve is a skilled freelance writer and editor with almost a decade of experience reporting on all things health, fitness, and travel.

Melissa Matthews Health Writer Melissa Matthews is the Health Writer at Men's Health, covering the latest in food, nutrition, and health.

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