Numbness and Tingling in Hands or Feet: When to See a Neurologist

May 18, 2026

Key Points

  • Numbness and tingling in hands or feet often indicate peripheral neuropathy affecting nerves outside your brain and spinal cord 
  • Classic symptoms include burning pain, sensitivity to touch, and the "stocking and glove" pattern 
  • Common causes include diabetes, vitamin deficiencies, autoimmune conditions, and certain medications 
  • Early diagnosis and treatment can prevent progression and reduce pain 
  • EMG and nerve conduction studies help identify the extent and cause of nerve damage 
  • Neurological Specialties offers comprehensive testing and personalized treatment plans


Your feet feel numb when you walk. Your hands tingle at night. You've noticed a burning sensation in your toes that won't go away, or maybe you're dropping things more often because your fingers feel clumsy. 


These aren't just minor annoyances you should ignore. They're potential signs of peripheral neuropathy, a condition where the nerves outside your brain and spinal cord become damaged. And the sooner you get it checked out, the better your chances of preventing it from getting worse. 


At Neurological Specialties, we help people understand and treat peripheral neuropathy every day. Let's walk through the symptoms you should watch for and when it's time to see a specialist. 


What Causes Numbness and Tingling in Your Hands or Feet?


Think of your peripheral nerves as an electrical wiring system that connects your brain and spinal cord to the rest of your body. These nerves carry signals back and forth: sensory information traveling to your brain (like touch, temperature, and pain), and motor commands traveling from your brain to your muscles (telling them when and how to move). 


When these nerves get damaged, the signals don't work properly. You might feel sensations that aren't really there (like burning or tingling), or you might not feel things you should (like the floor under your feet). 


Peripheral neuropathy can affect different types of nerves: 


Sensory nerves carry information about touch, temperature, pain, and position. When these are damaged, you get numbness, tingling, or pain. 


Motor nerves control muscle movement. Damage here causes weakness, muscle cramps, or loss of coordination. 


Most people with peripheral neuropathy have sensory symptoms first, which is why numbness and tingling are the classic warning signs. 


Recognizing the Symptoms of Peripheral Neuropathy


The symptoms of peripheral neuropathy vary depending on which nerves are affected and what's causing the damage. Here are the most common warning signs:


Sensory Symptoms (Most Common)

Numbness - A loss of feeling, often starting in the toes or fingertips. You might not notice small cuts or injuries, or you might feel like you're wearing invisible socks or gloves. 


Tingling or "pins and needles" - That prickly sensation like your foot fell asleep, except it doesn't go away when you move around. 


Burning pain - Many people describe a burning, searing, or electric sensation, especially in the feet. This often worsens at night. 


Sharp, shooting, or stabbing pain - Sudden jolts of pain that come and go, sometimes triggered by touch or movement. 


Extreme sensitivity to touch - Normal touch feels painful. Even bed sheets on your feet might hurt. This is called allodynia. 


Loss of coordination - Difficulty sensing where your feet are positioned makes walking and balance harder. You might trip more often or feel unsteady, especially in the dark.


Motor Symptoms

Muscle weakness - Difficulty lifting your foot, gripping objects, or performing tasks requiring fine motor control. 


Muscle cramps - Involuntary muscle contractions, especially in the legs and feet. 


Loss of reflexes - Your doctor might notice reduced or absent reflexes during examination. 


Muscle atrophy - In advanced cases, muscles may shrink from lack of nerve stimulation. 


The "Stocking and Glove" Pattern

Peripheral neuropathy typically starts in the longest nerves first, which is why symptoms usually begin in the toes and feet. As it progresses, the numbness or tingling moves up the legs in a pattern that looks like you're wearing stockings. 


Later, the same pattern might start in the fingertips and progress up the hands and arms like gloves. This distinctive pattern is actually a helpful diagnostic clue for Dr. Henkel when evaluating your symptoms. 


If you're experiencing any of these symptoms, especially if they're worsening or affecting both sides of your body, it's time to get evaluated. Call Neurological Specialties at (813) 876-6321 to schedule an appointment. Early diagnosis makes a real difference in treatment outcomes. 


Common Causes of Peripheral Neuropathy


Understanding what's causing your neuropathy is crucial for effective treatment. Here are the most common causes: 


Diabetes

Diabetes is the leading cause of peripheral neuropathy. High blood sugar levels damage nerves over time, leading to diabetic neuropathy. Even prediabetes can cause nerve damage. If you have diabetes and are experiencing numbness or tingling, don't wait to get it checked. 


Autoimmune Conditions

Your immune system can sometimes attack your own nerves. Conditions like rheumatoid arthritis, lupus, and Guillain-Barré syndrome can all cause peripheral neuropathy. 


Medications

Certain medications can damage nerves as a side effect, including some chemotherapy drugs, antibiotics, and medications used to treat HIV. If you developed neuropathy after starting a new medication, tell your doctor.


Infections

Infections like Hepatitis C and HIV can damage peripheral nerves.


Inherited Disorders

Some types of neuropathy run in families. Charcot-Marie-Tooth Disease (Hereditary Sensory and Motor Polyneuropathy) is the most common inherited neuropathy.


Other Causes

Additional causes include kidney disease, liver disease, hypothyroidism, and excessive alcohol use. 


Sometimes, despite thorough testing, we can't identify a specific cause. This is called idiopathic neuropathy, and while frustrating, it can still be managed effectively.


When Numbness and Tingling Need Medical Attention


Not every tingly sensation requires a trip to the neurologist, but certain patterns definitely warrant evaluation: 


See a specialist if you have: 


  • Numbness or tingling that has lasted more than a few weeks 
  • Symptoms that are progressively worsening 
  • Numbness or tingling in both feet or both hands (especially in the "stocking and glove" pattern) 
  • Burning pain, especially at night 
  • Balance problems or frequent tripping 
  • Difficulty with fine motor tasks like buttoning shirts 
  • Symptoms affecting your daily activities or quality of life 


Seek immediate medical attention if you experience: 


  • Sudden weakness in your arms or legs 
  • Inability to move a limb 
  • Loss of bowel or bladder control 
  • Severe pain that doesn't respond to over-the-counter medications 
  • Symptoms that started after an injury 


The key is that peripheral neuropathy usually develops gradually and affects both sides of your body symmetrically. Sudden or one-sided symptoms might indicate something else that needs urgent evaluation. 


How We Diagnose Peripheral Neuropathy

When you come to Neurological Specialties with symptoms of peripheral neuropathy, we conduct a thorough evaluation to identify both the presence of neuropathy and its underlying cause.


Medical History and Physical Examination 

Dr. Henkel will ask detailed questions about: 


  • Your symptoms and when they started 
  • Medical conditions, especially diabetes 
  • Medications you take 
  • Family history of neurological conditions 
  • Alcohol use and other lifestyle factors 


The physical exam includes testing sensation, reflexes, muscle strength, and coordination. Make sure to review what to bring to your appointment beforehand. 


EMG and Nerve Conduction Studies

EMG and nerve conduction studies are essential for diagnosing peripheral neuropathy. These tests measure how well electrical signals travel through your nerves and muscles. 


Nerve conduction studies show how fast signals move along your nerves and how strong those signals are. Slower speeds or weaker signals indicate nerve damage. 


The EMG portion evaluates muscle response to nerve signals, helping determine if the problem is in the nerves, muscles, or the connection between them. 


If you're nervous about testing, check out our guide on what to expect during an EMG. Most patients find it very manageable. 


Blood Tests

Comprehensive blood work can identify underlying causes: 


  • Blood sugar levels (fasting glucose, HbA1c for diabetes) 
  • Vitamin B12 and other vitamin levels 
  • Thyroid function 
  • Kidney and liver function 
  • Markers of inflammation or autoimmune disease 


Ready to get answers about your symptoms? Contact us at (813) 876-6321. We're located at 2816 W Virginia Ave, Tampa, FL 33607. 


Treatment Options for Peripheral Neuropathy

Treatment for peripheral neuropathy focuses on addressing the underlying cause and managing symptoms. 


Treating the Underlying Cause 

For diabetes - Tight blood sugar control is essential. This won't reverse existing damage but can prevent progression. 


For vitamin deficiencies - B12 injections or supplements can improve and sometimes reverse symptoms. 


For autoimmune causes - Biologic treatments, including the newer monoclonal antibodies, immunosuppressive medications, or IVIG therapy may help. 


For medication-caused neuropathy - Your doctor might adjust or change medications if possible. 


Managing Symptoms

Medications for nerve pain: 


  • Gabapentin or pregabalin 
  • Duloxetine or other SNRIs 
  • Topical treatments like lidocaine patches 

Lifestyle modifications: 


  • Careful foot care to prevent injuries you might not feel 
  • Proper footwear 
  • Regular exercise 
  • Avoiding alcohol 
  • Managing underlying conditions 

We offer various in-office treatments and work with you to develop a comprehensive management plan. 


For more information about nerve and muscular disorders, visit our service page. 


Diagnostic Testing (When Needed) 

For most people with typical chronic migraine, extensive testing isn't necessary. However, imaging or tests might be recommended if:

  • Your headache pattern has changed significantly or suddenly 
  • You have unusual neurological symptoms 
  • You're not responding to appropriate treatment 


Tests might include MRI or CT scans, blood tests, or EEG testing. 


Ready to get answers? Contact us at (813) 876-6321 to schedule your consultation. We're located at 2816 W Virginia Ave, Tampa, FL 33607. 



FAQs About Numbness and Tingling

  • Can peripheral neuropathy go away?

    This depends on the cause. Neuropathy from reversible causes like vitamin B12 deficiency can improve significantly with treatment. Diabetic neuropathy typically doesn't reverse completely, but progression can be slowed or stopped with good blood sugar control. Even when damage is permanent, symptoms can often be managed effectively. 

  • Why is numbness and tingling worse at night?

    Many people notice increased burning or tingling at night. This happens because there are fewer distractions when you're lying down, making you more aware of symptoms. Temperature changes and position can also affect nerve sensations. 

  • Is numbness or tingling more serious?

    Both can indicate peripheral neuropathy. Numbness might actually be more concerning because it means you've lost protective sensation and might not notice injuries. Tingling and pain, while uncomfortable, indicate the nerves are still functioning to some degree. 

  • How fast does peripheral neuropathy progress?

    This varies widely depending on the cause. Some types progress slowly over years, while others worsen more rapidly over months. This is why early diagnosis and treatment are important to slow or prevent progression. 



FAQs About Neurological Specialties 


  • What testing is available for peripheral neuropathy?

    We offer comprehensive diagnostic testing including EMG and nerve conduction studies, performed in-office for your convenience. We also coordinate blood work and any additional testing needed to identify the underlying cause. 

  • Does Dr. Henkel treat peripheral neuropathy?

    Yes, Dr. Henkel has extensive experience diagnosing and treating all types of peripheral neuropathy. He develops personalized treatment plans based on the underlying cause and your specific symptoms. 

  • How soon can I be seen for neuropathy symptoms?

    We understand that progressive numbness and pain are concerning. Call (813) 876-6321 and our scheduling team will work to accommodate your needs as quickly as possible. 

Don't Ignore Numbness and Tingling


Numbness and tingling in your hands or feet often start small but can progress if left untreated. The earlier you get diagnosed, the better your chances of preventing further nerve damage and managing symptoms effectively. 


At Neurological Specialties, Dr. Henkel and our team provide expert evaluation and treatment for peripheral neuropathy. We'll identify what's causing your symptoms and create a treatment plan that works for you. 


Contact us today at (813) 876-6321 to schedule your appointment. Don't let neuropathy symptoms control your life. 

Disclaimer: The information provided on this blog is for general informational purposes only and is not intended as, and should not be considered, medical advice. All information, content, and material available on this blog are for general informational purposes only. Readers are advised to consult with a qualified healthcare professional for medical advice, diagnosis, or treatment. The author and the blog disclaim any liability for the decisions you make based on the information provided. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.