Numbness in Hands & Feet

Pins and needles in your hands or feet, numbness, or a tingling electric sensation—
Numbness can be caused by various factors, including nerve, vascular, spinal, and internal medicine conditions.
Ignoring it as "just temporary" could lead to missing a stroke or a serious neurological disorder. If you experience persistent numbness that concerns you, it's crucial to identify the cause promptly.

• Thoroughly identify the cause through interviews, palpation, neurological examinations, X-rays, and blood tests
• Address a wide range of causes including brain, spinal, peripheral nerve, and internal medicine conditions
• Provide referral letters to specialized hospitals for MRI and CT scans as needed
• No appointment necessary / Walk-ins welcome | Open daily from 9 AM to 9 PM

👉 Walk-ins without an appointment are also welcome. Please feel free to consult us first.

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What is Numbness?

Numbness is a general term for a state where normal sensation is altered. It can be described in various ways, such as "pins and needles," "tingling," "dull or lost sensation," "feeling like something is stuck when touched," or "an uncomfortable sensation different from pain."

Medically, numbness is broadly categorized into two types. One is called positive symptoms, where abnormal sensations like tingling or pins and needles occur. The other is negative symptoms, where sensation becomes dull or disappears. Both are caused by nerve damage, but their causes and severity differ.

The causes of numbness are diverse, ranging from common everyday occurrences like "temporarily reduced blood flow from crossing legs" to conditions requiring treatment such as "stroke," "spinal cord diseases," and "diabetic neuropathy." In particular, sudden numbness, numbness on one side, or numbness accompanied by facial numbness may indicate a cerebrovascular disorder and require immediate attention.

⚠️ In these cases, seek emergency medical attention immediately:

• Sudden numbness in one hand, foot, or face (possible stroke or cerebral hemorrhage)
• Difficulty speaking or slurred speech along with numbness
• Facial distortion or inability to move one side of the face along with numbness
• Severe headache along with numbness
• Blurred vision or double vision along with numbness
• Inability to walk, stand, or maintain balance
• Difficulty with urination or defecation

⚠️ In these cases, seek medical attention promptly:

• Numbness has lasted for several days or more
• The area of numbness has spread
• Weakness has developed in the hands or feet
• Numbness is accompanied by neck or back pain
• Numbness has appeared while undergoing treatment for diabetes, high blood pressure, or high cholesterol
• Pins and needles or dull sensation in both soles of the feet
• Numbness in the fingertips has persisted for a long time

Main Causes of Numbness

1. Numbness due to Brain and Spinal Cord Diseases

Among the conditions that cause numbness, damage to the brain and spinal cord (central nervous system) is the most critical. Early treatment for these conditions significantly affects the prognosis, so they should not be overlooked.

Stroke, Cerebral Hemorrhage, TIA (Transient Ischemic Attack)

When blood vessels in the brain become blocked or rupture, it causes impairment in the sensory and motor functions managed by that area. Numbness often occurs on one side (right hand and right foot, or left hand and left foot), and may be accompanied by facial numbness, speech impairment, visual disturbances, and headaches.

TIA (Transient Ischemic Attack) is a condition where symptoms like numbness and paralysis disappear spontaneously within minutes to hours. Many people ignore it, thinking "the numbness went away, so it's fine," but TIA is often a precursor to stroke, and there is a high risk of a full-blown stroke occurring within a few days. Therefore, even if the symptoms disappear, it is absolutely necessary to seek medical attention.

Cervical Myelopathy and Spinal Cord Tumors

When the spinal cord is compressed due to deformation of the cervical vertebrae (neck bones) or tumors, symmetrical numbness and weakness appear below the compressed area (e.g., both hands and both feet). Symptoms may include difficulty using hands effectively, difficulty using chopsticks, or difficulty buttoning clothes.

2. Numbness due to Spinal and Peripheral Nerve Diseases

Cervical Disc Herniation and Cervical Spondylosis

When a disc in the neck protrudes or bone deformities occur, it compresses nerve roots or the spinal cord. This results in numbness and pain in the shoulder, arm, and hand, and symptoms change with neck movement. Numbness often radiates from one arm to the fingertips.

Lumbar Disc Herniation and Lumbar Spinal Stenosis

When nerves in the lower back are compressed, numbness and pain radiate from the buttocks to the thigh, calf, and foot (sciatica). A characteristic symptom of lumbar spinal stenosis is intermittent claudication, where the legs become numb when walking, forcing a stop, and relief is found by leaning forward.

Carpal Tunnel Syndrome

This condition occurs when the median nerve, which runs through the wrist, is compressed by the wrist ligament, causing numbness in the thumb, index finger, middle finger, and half of the ring finger. It is common in women, pregnant women, and menopausal women, and numbness often worsens at night or in the early morning. Diagnosis is made through clinical findings such as tapping the wrist (Tinel's sign) and flexing the wrist (Phalen's maneuver).

Cubital Tunnel Syndrome

This condition occurs when the ulnar nerve is compressed on the inside of the elbow, causing numbness in half of the ring finger and the little finger. It is common in people who habitually rest their elbows or maintain a bent elbow posture for extended periods.

Thoracic Outlet Syndrome

This condition occurs when the nerves and blood vessels from the neck to the shoulder and arm are compressed around the collarbone, leading to numbness, dullness, and weakness in the arm and hand. It is common in women with sloping shoulders and those who frequently carry heavy loads. A characteristic symptom is that symptoms tend to appear when the arm is raised.

Tarsal Tunnel Syndrome

This condition occurs when a nerve is compressed on the inside of the ankle, causing numbness in the sole of the foot and toes. It is the foot equivalent of carpal tunnel syndrome.

3. Numbness due to Internal Medicine Conditions

Diabetic Neuropathy

This is a complication where peripheral nerves are damaged due to long-term diabetes. It is characterized by numbness, burning sensation, and decreased sensation starting from both soles of the feet, often described as feeling like wearing socks or having something stuck in the soles of the feet. As it progresses, similar symptoms appear in the hands.

Diabetic neuropathy progresses more easily with poor blood sugar control, and impaired sensation can lead to unnoticed foot injuries, resulting in serious infections and gangrene. If you have diabetes and experience numbness in your feet, please seek medical attention promptly.

Hypothyroidism

Insufficient thyroid hormones can lead to numbness in the hands and feet, swelling, fatigue, and cold sensitivity. Diagnosis can be made by checking thyroid hormones (TSH, FT4) in a blood test.

Vitamin B12 Deficiency and Folate Deficiency

A deficiency in vitamin B12 or folate can impair peripheral nerve function, causing numbness in the hands and feet, sensory disturbances, and anemia. It is common in vegetarians, those who have undergone stomach surgery, and the elderly. It can be confirmed by a blood test and often improves with supplementation.

Polyneuropathy (Guillain-Barré Syndrome, etc.)

This is a disease where peripheral nerves become inflamed, often triggered by an infection. It is characterized by rapidly progressing numbness and weakness starting from both feet, and requires early treatment.

Circulatory Disorders (Peripheral Artery Disease, Raynaud's Disease)

When blood flow to the legs decreases due to arteriosclerosis, it can cause numbness, cold sensation, and pain during walking in the legs. Smoking, diabetes, high blood pressure, and dyslipidemia are risk factors. Raynaud's disease is a condition where fingers turn white, then blue, then red due to cold or stress, accompanied by numbness and pain.

4. Other Causes

Cause	Characteristics
Hyperventilation Syndrome	Overbreathing causes a drop in blood carbon dioxide, leading to numbness in both hands and around the mouth. Often accompanied by anxiety and panic.
Drug-induced	Some anti-cancer drugs, antibiotics, and antihypertensives can cause numbness as a side effect.
Postherpetic Neuralgia	Nerve pain and numbness may persist even after shingles has healed.
Multiple Sclerosis	Demyelinating disease of the central nervous system. Common in young women. Numbness, vision impairment, and dizziness occur repeatedly.
Menopause / Autonomic Nervous System Imbalance	Hormonal changes during menopause or an imbalance in the autonomic nervous system can cause numbness in the hands and feet. Often accompanied by general fatigue, hot flashes, and palpitations.

Key Points to Identify the Cause of Numbness

Characteristic of Numbness	Suspected Cause
Sudden, one-sided hand, foot, and face numbness	Stroke, cerebral hemorrhage (emergency)
Neck pain and numbness in one arm and hand	Cervical disc herniation, cervical spondylosis
Lower back pain and numbness from buttocks to feet	Lumbar disc herniation, spinal stenosis
Thumb to middle finger, worse at night	Carpal tunnel syndrome
Ring finger to little finger, worse when elbow is bent	Cubital tunnel syndrome
Starts from both soles of feet, symmetrical	Diabetic neuropathy, vitamin deficiency
Numbness when walking, relieved by leaning forward	Lumbar spinal stenosis
Numbness when raising arm, sloping shoulders	Thoracic outlet syndrome
Fingers turn white and numb due to cold	Raynaud's disease
After hyperventilation, simultaneously in both hands and around mouth	Hyperventilation syndrome

Examinations and Treatment at Our Clinic

Examination/Procedure	Purpose/Content
Interview and Neurological Examination	Detailed confirmation of the location, extent, onset, and exacerbating factors of numbness. Evaluation of tendon reflexes, muscle strength, sensation, and coordination.
X-ray Examination (X-ray)	Confirmation of cervical/lumbar spine deformation, disc space narrowing, and bone condition.
Blood Tests	Confirmation of necessary items for differential diagnosis of internal causes, such as blood sugar, HbA1c (diabetes), thyroid hormones, vitamin B12, folate, inflammatory response, kidney function, and lipids.
Blood Pressure Measurement and Pulse Wave Velocity Test	Evaluation of arteriosclerosis and circulatory disorders.
Treatment/Prescription	Prescription of medications according to the cause (e.g., neuropathic pain medications, vitamins, blood sugar control medications).
Referral to a Specialized Hospital	Preparation of a referral letter when cerebrovascular disease is suspected (MRI/CT), for spinal conditions requiring surgery, or when detailed examination by a neurologist/neurosurgeon is necessary.

Blood test results can be communicated as early as the next day if you visit by 5 PM. If you experience "sudden numbness" or "numbness accompanied by difficulty speaking or facial distortion," please visit an emergency hospital instead of our clinic.

Consultation Flow

1. Online booking or direct walk-in
   If you experience sudden and urgent numbness (numbness in one hand, foot, or face; speech impairment), please visit an emergency hospital instead of our clinic. For chronic or unexplained numbness, please feel free to visit us.
2. Reception and completion of medical questionnaire
   Please fill in the area of numbness, when it started, when it is strongest, presence of pain, weakness, and medical history (e.g., diabetes, high blood pressure).
3. Doctor's examination
   The doctor will check the distribution of numbness, tendon reflexes, muscle strength, and sensation to determine the urgency and possible causes.
4. Examinations (X-ray, blood tests)
   Examinations will be performed in-house as needed. Blood test results will be communicated as early as the next day.
5. Diagnosis, treatment, and referral
   We will explain the cause and prescribe/provide immediate treatment for treatable internal medical conditions. If specialized examinations for the brain, spine, or nerves (MRI, CT, nerve conduction velocity tests) are necessary, we will provide a referral letter.
6. Payment and departure
   We will explain precautions for daily life, the approximate timing for your next visit, and how to proceed with referred facilities.

Frequently Asked Questions

The numbness appeared temporarily and then disappeared. Do I need to see a doctor?
Even if the symptoms have disappeared, it could be a precursor to a stroke (TIA). Especially if it was accompanied by one-sided numbness in the hands, feet, or face, speech impairment, or visual disturbances, you must seek medical attention as soon as possible, even if the symptoms have subsided. "It got better so it's okay" is a dangerous assumption.

I've had numb feet for many years. Is it okay to leave it?
If numbness in both soles of the feet persists for a long time, diabetic neuropathy, vitamin B12 deficiency, or lumbar spinal stenosis may be suspected. Leaving it untreated can lead to further loss of sensation, unnoticed foot injuries, and severe conditions. Please seek medical attention promptly to determine the cause.

My fingers are numb. Which department should I visit?
You can consult with orthopedics, neurology, or internal medicine. At our clinic, we narrow down the cause to some extent through interviews, neurological examinations, X-rays, and blood tests, and if necessary, we provide a referral letter to a specialized department. If you "don't know where to go," please consult us first.

I have diabetes. Is my foot numbness caused by diabetes?
If you have diabetes, foot numbness is highly likely due to diabetic neuropathy. However, other causes such as lumbar spine disease may also be involved. We recommend checking this in conjunction with your blood sugar control status.

Can I get an MRI at your clinic?
Our clinic does not have MRI equipment, so if a detailed evaluation for cerebrovascular disease, spinal cord disease, or disc herniation is necessary, we will provide a referral letter to an affiliated medical institution.

My numbness is accompanied by pain. Is it a nerve disorder?
"Neuropathic pain," where numbness and pain occur simultaneously, can be caused by postherpetic neuralgia, diabetic neuropathy, or disc herniation. Standard pain relievers are often ineffective, and medications for neuropathic pain (such as pregabalin and duloxetine) can be effective in some cases. Please mention both numbness and pain when you visit.

Clinic Hours and Access

Item	Content
Clinic Name	Jujo Ekimae Halu Internal Medicine & Dermatology Clinic
Consultation Hours	Monday to Sunday, 9:00 AM to 9:00 PM
Closed	None (irregular holidays)
Address	J&MALL 1F, 2-27-1 Kami-Jujo, Kita-ku, Tokyo 114-0034
By Train/On Foot	Approx. 1-2 minutes walk from JR Saikyo Line "Jujo Station," J&MALL 1st floor
By Bus	Right in front of the Kokusai Kogyo Bus "Jujo Station" bus stop
By Car	Please use nearby coin parking lots
Contact	TEL: 03-6698-2509　／　Official LINE: https://lin.ee/DRxcelo

Official LINE　 Call Us　 Priority with Appointment