Most of us have felt that unmistakable pins-and-needles sensation after sitting too long. A quick shake-out usually makes it disappear. But what if it doesn’t go away or keeps coming back? If you’re feeling tingling or numbness in your leg, ankle, foot, or toes, your nerves could be signaling a deeper issue.
Let’s break down what causes that distinctive “falling asleep” feeling and the signs it’s time for help.
What Does Pins and Needles in the Lower Extremities Feel Like?
When your foot, ankle or leg “goes to sleep, the numbness and tingling is called paresthesia. That “falling asleep” sensation may progress into dysesthesia, a more intense, unpleasant sensation like burning, stabbing, or electric shocks. Both are signs that your nerves may be irritated or damaged and shouldn’t be ignored.
Here’s how nerve issues can show up:
- A crawling or prickling sensation [1]
- A buzzing or electric shock-like feeling [2]
- A sense of tightness or pressure [3]
- Loss of feeling or decreased sensitivity to touch, heat, or pain [1, 3]
The sensations may be occasional or constant, affecting just your toes, ankle, foot, or even most of your leg.
Numbness vs. Tingling: What’s the Difference?
Numbness means you’ve lost some (or all) feeling in an area, while tingling feels more like pins and needles or buzzing.[4] These sensations often occur together, as in peripheral neuropathy, but can point to different underlying conditions.
Why Are My Legs and Feet Tingly?
Tingling in your lower body can be caused by something as simple as nerve pressure or possibly indicate a deeper issue. When that pins-and-needles or numb feeling is relentless, it’s often your body’s way of saying your nerves need attention.
Short-Term Causes
Some causes of tingling or numbness are temporary and do not usually cause concern. These include:
- Sitting or standing too long in one position: Temporary nerve compression [4]
- Wearing tight shoes or socks [4]
- Vitamin B12 deficiency: Affects how your nerves function [5]
- Certain medications: Chemotherapy drugs [2]
- Injury: A sprain or sudden trauma [2]
More Serious Causes
If the sensation is frequent, spreading, or worsening, it may indicate a chronic condition that requires evaluation and treatment. Severe conditions that can cause lower limb numbness include:
- Diabetic Neuropathy: High blood sugar over time can damage peripheral nerves, especially in the feet and legs. [3]
- Pinched Nerve or Spinal Issues: Pressure on nerves that travel down the legs.[ 1]
- Sciatica: Sciatic nerve compression causes radiating pain, numbness, and tingling from the lower back to the foot.
- Tarsal Tunnel Syndrome: Similar to carpal tunnel syndrome, but in the ankle, compression of the tibial nerve causes tingling, burning, or shooting pain in the foot. [6]
- Peripheral Artery Disease (PAD): Reduced blood flow due to narrowed arteries can lead to numbness and cramping in the legs. [7]
- Fibromyalgia: May include widespread tingling or numbness.[7]
- Multiple Sclerosis (MS): Nerve damage causing leg numbness or a buzzing sensation (“Lhermitte’s sign”). [7]
- Stroke or TIA (mini-stroke): Sudden numbness—especially on one side of the body—can be a red flag for stroke.[3] Call 911 immediately if you suspect a stroke.
How Is Numbness or Tingling in the Legs and Feet Treated?
Treatment depends on what’s causing your symptoms, so a proper diagnosis is essential. Nerve-related sensations and loss of feeling can range from mildly annoying to completely debilitating.
A pain specialist or neurologist may recommend a combination of the following treatment options:
- Medications: Anti-inflammatories, nerve pain medications (such as gabapentin), or treatment of underlying conditions like diabetes.
- Lifestyle changes: Better blood sugar control, ergonomic adjustments, or diet changes (especially if a vitamin deficiency is involved).
- Physical therapy: To stretch and strengthen areas causing nerve compression
- Interventional treatments: Corticosteroid injections, nerve blocks, TENS or other minimally invasive options like peripheral nerve stimulators that calm irritated nerves using mild electrical pulses.
- Alternative therapies: Acupuncture, massage, or yoga may help ease nerve-related discomfort.
When Should I See a Pain Specialist for Tingling or Numbness in My Legs, Feet, or Toes?
So, how do you know when it’s more than just an annoying tingle? While occasional pins and needles aren’t usually serious, ongoing or worsening symptoms could mean it’s time to get expert help.
Here are some signs you should see a pain specialist:
- Persistent or getting worse
- Interfering with sleep, walking, or daily activities
- Accompanied by weakness or pain
- Affecting both sides or increasing in size/area
Numbness or tingling might seem minor, but it can be your body’s way of saying something’s off, and nerve pain is easier to manage when caught early.
Don’t ignore that buzzing in your legs, feet or ankles. Your pain specialist can help you identify the cause and develop a personalized plan to restore your comfort and function.
Resources:
- Freedman M. Numbness – Neurologic Disorders. Merck Manuals Professional Edition [Internet]. Revised July 2024. Accessed June 19, 2025. Available from: https://www.merckmanuals.com/professional/neurologic-disorders/symptoms-of-neurologic-disorders/numbness
- Bailey A. Common Causes of Numbness in Your Feet. VeryWellHealth [Internet]. Updated April 14, 2025. Accessed June 19, 2025. Available from: https://www.verywellhealth.com/numbness-in-feet-7507980
- Numbness. Cleveland Clinic [Internet]. Accessed June 19, 2025. Available from: https://my.clevelandclinic.org/health/symptoms/21015-numbness
- Huizen J. Why Are My Legs and Feet Numb? Medical News Today [Internet]. Updated January 25, 2024. Accessed June 19, 2025. Available from: https://www.medicalnewstoday.com/articles/321560
- Vitamin B12 or folate deficiency anaemia. NHS Inform [Internet]. Accessed June 19, 2025. Available from: https://www.nhsinform.scot/illnesses-and-conditions/nutritional/vitamin-b12-or-folate-deficiency-anaemia/#
- Dix M. 16 Causes of Tingling in Feet and How to Treat Them. Healthline [Internet]. Updated January 26, 2024. Accessed June 19, 2025. Available from: https://www.healthline.com/health/tingling-in-feet
- Zimlich R. Causes of Numbness in Legs and Feet. Healthline [Internet]. Accessed June 19, 2025. Available from: https://www.healthline.com/health/fibromyalgia/numbness-in-legs-and-feet
