Numbness and Tingling in Hands and Feet: What's Causing It?

Almost everyone has experienced the temporary "pins and needles" feeling after sitting in an awkward position. That kind of numbness is harmless and resolves in seconds. But when numbness or tingling in the hands and feet keeps coming back, gets worse over time, or never fully goes away — it's a sign that something is affecting your peripheral nerves.

What Causes Persistent Numbness and Tingling?

The most common causes are:

1. Peripheral Neuropathy from Diabetes

The most common cause in India. High blood sugar damages the small blood vessels that supply the nerves — particularly the long nerves supplying the feet and legs (which is why the symptoms typically start in the feet and move upward). Often presents as burning, tingling, or loss of sensation in both feet. Up to 50% of people with long-term diabetes develop some degree of neuropathy.

2. Vitamin B12 Deficiency

Extremely common in India, especially among vegetarians. B12 is essential for the myelin sheath that protects nerve fibres. Deficiency causes numbness, tingling, weakness, and in severe cases, subacute combined degeneration of the spinal cord. A simple blood test diagnoses it, and B12 injections can reverse the damage if caught early.

3. Carpal Tunnel Syndrome

Compression of the median nerve at the wrist. Causes numbness and tingling in the thumb, index, and middle fingers — typically worse at night or when holding a phone. Very common in people who type or do repetitive hand work. Confirmed by a nerve conduction study (NCS).

4. Cervical or Lumbar Disc Problems

A bulging disc in the neck can compress the nerves supplying the arms, causing tingling in one or both hands. A disc problem in the lower back can cause similar symptoms in the legs. Associated with neck/back pain and usually affects one side more than the other.

5. Thyroid Disease

Hypothyroidism (low thyroid) can cause neuropathy with numbness and tingling, particularly in the hands. A simple thyroid function test can identify this.

6. Alcohol-Related Neuropathy

Chronic alcohol use damages peripheral nerves. Presents as burning pain and numbness in the feet and lower legs.

When to See a Neurologist

See a neurologist if:

• Numbness or tingling is persistent (lasting more than a few days or coming back regularly)
• It is spreading — starting in the feet and moving upward, or into both hands
• There is associated weakness, difficulty with balance, or problems with fine motor skills
• You have diabetes and notice any change in sensation in your feet
• The tingling is accompanied by pain — burning, shooting, or electric-shock pain

Diagnosis

A neurologist will examine your nerve function clinically and order:

• NCS (Nerve Conduction Study) and EMG (Electromyography) — the gold standard for diagnosing peripheral neuropathy and identifying which nerves are affected
• Blood tests — HbA1c, B12, thyroid, kidney function, complete blood count
• MRI if spinal cord or disc compression is suspected

"Peripheral neuropathy is highly treatable when the cause is identified and addressed. Vitamin B12 deficiency neuropathy can reverse completely. Diabetic neuropathy can be halted and symptoms improved with tight blood sugar control and specific nerve pain medication."

Dr. Anand Karnam provides nerve conduction studies and neuropathy management at Sri Anand Child and Neuro Center, Chanda Nagar. Serving Ameenpur, Miyapur, Kondapur and all of western Hyderabad. Call +91 90633 66983.

Medically reviewed by Dr. Anand Karnam, MBBS · DNB · DrNB · FWHS. Follows IAN peripheral neuropathy guidelines and API standards of care.